A Gentle C-Section

Jessica Massey delivered her first child after a long labor and emergency cesarean section, also known as a C-section. “It was really difficult. The lights, the noise, that little bit of chaos…” As a nurse, currently on leave from a case management position with the state of Vermont, Massey knew that mothers who delivered vaginally were able to have their newborn set directly on their chests after delivery. Unfortunately, the surgical drape—typically used to create a sterile environment and to shield the mother and her birth partner from seeing the operation unfold—makes that an impossibility for babies delivered by C-section. Jessica missed that immediate closeness with her baby.

When it came time to birth her second child, she chose a scheduled C-section at Southwestern Vermont Medical Center (SVMC). During an appointment with her provider, Kimberley Sampson, MD, of SVMC OB/GYN, she shared her anxiety about entering a situation like her first C-section. She was greatly relieved to learn that a new surgical drape, which includes a window through which to pass the baby to her chest, fulfills the same important safety function while giving her immediate skin-to-skin connection with her infant.

Massey remembers thinking, “Anything that can get me closer to that natural birth, without compromising my safety, is ideal.”  

Giving all birthing parents a birth experience that matches their hopes is the goal of all OB providers and the SVMC Women’s and Children’s Services (WCS) department. Over several years, they have instituted many changes as a part of their “Gentle C-section” program for scheduled C-sections.

“We are always asking, ‘how do we make the surgical environment more comfortable for the family,’” said Sampson. “By providing families with more options to shape their delivery experience, we make scheduled C-sections quieter, warmer, and more personal.”

In the past, for instance, a birth partner would have waited outside as the anesthesiologist administered the anesthetic, which allows the birthing parent to remain alert while also rendering the surgery, itself, painless. Now, the birth partner can be with the birthing parent from start to finish.

Families who schedule C-sections can request changes to the non-surgical lighting, play music, and take photos. Screens and monitors are largely out of the patients’ sight, and medical equipment volume is set lower than in other operating situations.

“These are small things we can do to make the delivery experience for scheduled C-sections more comfortable for families,” Sampson said.

In addition to the new, pass-through drape, which allows immediate skin-to-skin contact between the birthing parent and the newborn, nurses provide lots of time for babies and families to bond in the first hour or two after birth.

“It’s called the ‘Golden Hour,’” said Deb Mone, RN, a nurse on the Women’s and Children’s Unit at SVMC for the past 41 years who was instrumental in securing the pass-through drape and implementing gentle C-section protocols. “Infants can have difficulty regulating their temperature on their own. When they have skin-to-skin contact with their birth parent, the infant regulates to match the parent’s temperature.”

Nurses delay weighing and bathing the infant until after this crucial time. Parents can also initiate breastfeeding and often have great success in those first precious hours of life, Mone explains.  

Finally, there are more pain-management options for all birthing families.  Enhanced recovery options have eliminated the need for narcotics for most birth parents, helping them be more alert and engaged and less dizzy and nauseous in their first days after the birth.

“Obstetricians, midwives, anesthesiologists, the operating room staff and WCS nurses, were all on board with making these changes for our families,” Mone said. “That makes it even more special.”

When the day of her scheduled C-section arrived, Massey was calm and ready. The entire experience was far less hectic than her first. “I was able to walk into the operating room and get settled. My husband was there the whole time.”

Having her baby delivered directly from her womb to her chest was much better for her.

“It gives a little piece of the natural birth back to mothers who deliver by C-section,” Massey said. “Whoever is responsible for bringing the new drape here and incorporating it into births is amazing,” she said.

The team likes it better too.

“There’s something so magical about being there with a family for the birth of their child. These changes make it even better for families delivering by C-section,” Mone said. “The look on Jess’s face when Dr. Sampson handed the baby to her through the drape… it was beautiful.”

Photo Credit: megancrossphotography.zenfolio.com