The Family Centered Cesarean
With the drape lowered, a belly birth babe emerges slowly into the world, as they would in a vaginal birth.
Cesarean Birth in the USA
In the USA, approximately 30% of all babies are born via cesarean section, or belly birth. In the state of Mississippi, the rate can be as high as 38% of all live births (source: CDC). There are many reasons that necessitate a cesarean-assisted birth: personal choice, medical conditions such as preeclampsia, breech baby with no providers that can catch a vaginal breech, and birth emergencies for mom or baby. The World Health Organization does state that the ideal rate of cesarean birth is 10-15% of all births— nearly half of the current rate here in the USA. While it is important to be aware of these rates and work to prevent unnecessary cesareans, it is not the focus of this article. I’m here to talk about the awe and the beauty that can surround a belly birth.
A Powerful Way of Being Born
Unfortunately, families do not always feel in awe or beautiful about a cesarean. If it was not their choice, they may have felt hurried or rushed, sad, angry, scared, confused, or unfulfilled. There is not always a circle of support ready to talk through what it means to give birth this way. Families may receive overt or covert messages from society, friends, or family of being “less-than” compared to vaginal birth, or that they took “the easy way out.” They may feel lost among their peers who had vaginal births.
I’m calling false on that. There is no hierarchy, no easy way out, no wrong feelings or wrong experiences. There can be trauma, but even in trauma, there can be love and magic.
While all the feels are welcome, to be expressed and handled with care and understanding, cesarean birth does not have to be inherently sad, disempowering, or terrifying. Whether you have your baby vaginally or with the support of doctors through a cesarean, you are still the one giving birth to your baby. It is still your birth to claim. It is yours to decide how the environment should feel.
The Difference of Family Centered
There are unchangeable facts of having a belly birth that can’t be avoided, like birthing in the operating room (OR), and having localized anesthesia through an epidural or spinal block. Hospitals often have a series of guidelines and protocols, but that does not mean your birth has to be clinical, cold, or exclusionary.
The family centered cesarean is the idea of creating a gentle, calm, and inclusive environment in the OR. It, like the name suggests, puts the family at the center; not the hospital staff or policies. Many of the things that new parents want during their birth (low lights, music, calming touch, immediate skin to skin, delayed cord clamping) are not out the window if you are having a cesarean birth.
Elements of a Family Centered Cesarean
Mama meets her baby for the first time through a clear drape.
“They provided us with a clear curtain so that we could be a part of the whole experience and lifted baby to my chest instantly. [Baby] grabbed my finger through the curtain before the nurse even got us skin to skin,” writes the Mama shown in the picture above. Although her birth plan quickly changed from the out-of-hospital to planned cesarean, she describes her experience as “…a birth, not a surgery; a holy transformation. Our belly birth was beautiful.”
These are words I do not typically hear when describing a cesarean birth. But there is no reason why this cannot be the norm.
“When we realized that our birth would not be in the controlled, homey environment we had prepared for, we took some time to mindfully prepare ourselves to bring ‘home’ with us,” she writes. “We collected twinkle lights, essential oil roll-ons (can’t diffuse in hospital), LED candles, some pictures, created affirmation cards and spent time visualizing a beautiful, safe hospital delivery.” Although not every family wants these types of items at their birth, the point she makes here is key: bringing “home” with you into the OR as much as possible is welcome, and beneficial. And that can be whatever it is that reminds you of home…smells of home, your favorite music, loving and mindful touch.
When creating family centered cesarean birth preferences, the first step is to gauge the support of your team. Do you have a doula? If so, are they familiar and comfortable supporting a family centered belly birth? Is your team of OBs supportive of your preferences? Are there certain doctors in the practice that respect families more than others?
Once you have your team encircling you, spend some time with your partner and doula visualizing your most ideal birth. Speak it out loud, write it down, and hold it there in your mind and heart.
“It was a birth, not a surgery; a holy transformation. Our belly birth was beautiful.”
As you sit down to write your birth plan, these are some things you may want to include:
Have time before the birth to ground and center with your birth team and decorate the room,
To shave yourself instead of the nurse doing it,
To keep the energy in the room before going to the OR calm, respectful, and intentional,
Have a playlist already made with music you choose to play during your birth,
Have a clear drape or make sure the drape is lowered as your baby emerges,
Request that the birth team keep small talk or irreverent talk (weekend plans, sports, etc.) out of the space before and during the birth, and keep conversations directly related to the birth,
Have a cotton ball with essential oils of lavender, peppermint, or citrus in your gown pocket to reduce nausea and vomiting during the birth,
Request a non-drowsy anti-nausea medication before the birth (Zofran),
Have your arms free during the birth,
Have EKG leads placed on your back or out of the way so your chest is free for your baby,
Have IV's and hookups on your non-dominant arm so you can freely touch your baby,
Have your gown and bra in a place that is ready to have your baby skin to skin with you,
Have your partner take their shirt off beneath their gown so they can do skin to skin with your baby in the event that you are unable to,
Have father/birth partner be the one to announce when baby is here/announce the sex, if unknown,
Take photos (videos are not allowed, but allll the pictures are!),
Have the doctors explain what they are doing during the birth, if desired,
Have a gentle and slow emergence of the baby, to stimulate the squeezing that happens during a vaginal birth,
Have them ask if you're ready to meet your baby, if desired,
To initiate breast/chestfeeding while still in the OR,
Have the umbilical cord kept long so your partner can cut it and have that experience,
Have them keep the placenta and cord so you can look at it once you're back in the room, if desired,
Have all newborn assessments done on your chest and not on the warmer.
Family-Centered Postpartum Recovery
The beautiful reminder of magic made material.
There is no way of knowing how you might feel after your belly birth. There is no recipe for predicting how anyone feels after becoming a parent, no matter how it happens. It might be weeks, months, or even years before the body and mind are ready to meet again and discuss your birth. No matter what feelings arise— joy, grief, anger, exaltation, numbness, confusion, love— remember that a family centered birth does not end when your baby arrives. Continue to put yourself in the center as you heal and make sense of the new life you have created, and are actively creating.
Join a support group. Go for walks in nature. Eat your favorite foods. Give yourself the kindest words. Snuggle and sleep in. Talk about your birth. Or don’t talk about it, if that’s what you need. Just as you did when you prepared for your birth, visualize and hold in your heart the kind of care you need. Look at your family holistically, recognizing that the wellbeing of each one of you is the wellbeing of all.
It is incredibly sacred, incredibly powerful, incredibly hard to have a baby. To all cesarean-assisted birth parents: you’re a badass. You are courage incarnate. Fierce love embodied. Resilience, strength, survival extraordinaires, who should be listened to, honored, and celebrated for the holy work of doing the most wonderfully challenging and most breathtakingly powerful. Your birth matters. Your story matters. Your scar is beautiful, and it matters.
May your family always be put in the center.
For more resources on family centered cesarean birth or info about having a belly-birth friendly doula on your team, let's connect!
Thank you deeply, humbly, to my amazing clients for sharing their word medicine and photos. Your forever evolving story is an inspiration and gift.
