July 15, 2013

More women opting for ‘gentle’ C-section births

Advocates say the procedure promotes better newborn health.

Rants, raves, reviews and resources for Dallas-Fort Worth parents

Two and a half years ago, complications led to Hilary Pearson’s daughter Rosemary being born via emergency cesarean.

Besides a quick nuzzle on the cheek and a brief glimpse of Rosie’s face, it was about 30 minutes before Pearson was able to move out of the operating room and into recovery to hold her daughter for the first time.

But when Pearson gave birth to her son Truman at Texas Health Harris Methodist Hospital Fort Worth this month, things were different. Moments after he was delivered during a C-section, Pearson was able to cradle her newborn son to her chest and admire his thick brown hair.

“It was really nice to be able to hold him and feel him. He was snuggling in,” said Pearson, of Fort Worth. “I kept him on my shoulder and talked to him a little bit. He was real calm and mellow for a long time.”

Called a “gentle” C-section, Pearson’s procedure is part of a new movement in baby delivery that advocates placing a newborn on the mother’s chest immediately after the birth instead of whisking the child off to a warming table to be cleaned and checked.

Advocates contend that this approach keeps the baby warm, improves mother-infant interaction and helps the mother breastfeed successfully, according to the World Health Organization.

Realizing the importance of immediate skin-to-skin contact between moms and babies, Texas Health Resources has begun offering gentle C-sections at three of its area hospitals, in Fort Worth, Cleburne and Bedford.

“We have patients who have spent years grieving a C-section because it didn’t turn out the way they wanted. Now they can have such wonderful memories of that baby being right there and seeing their baby born and having that skin-to-skin contact,” said Kathleen Donaldson, head of certified nurse-midwifery at Texas Health Harris Methodist Hospital Fort Worth.

Cesarean births increasing

The hospital network made the change at the request of patients, Donaldson said.

Typically during a C-section procedure, a woman’s view of her child’s birth is blocked by a drape and her arms may be restrained. Under the “gentle” procedure, the mother gets to enjoy some of the same experiences as a woman giving birth vaginally.

“To go into an operating room where they know initially that their babies will be delivered sight-unseen from them and going immediately into a warmer across the room, that has been a frustration for them,” Donaldson said.

The rate of cesarean births in the United States is increasing and currently averages about 32 percent, according to a 2010 report. Additionally, 32 percent of U.S. hospitals implement skin-to-skin care for most women and babies within two hours after a cesarean birth without complications, according to the Centers for Disease Control.

A growing number of hospitals across the country are now offering gentle C-sections, which Dr. Ruth Wiley, an OB/GYN at Texas Health Harris Methodist Fort Worth, said may “seem novel right now but in a few years is going to become the accepted standard of care.”

“Anything that can be done that is going to promote newborn and maternal bonding and promote successful breastfeeding is going to benefit both mother and child,” said Wiley, adding that it typically can be about 30 minutes before a mom who undergoes a C-section is able to hold her baby.

“Anecdotally, it would appear babies normalize their heart rates and respiration more rapidly when they are placed with their mothers versus placed on a warmer.”

Changes in operating room

Over the past 30 years, changes in the operating room have allowed mothers to be more active participants in their deliveries — such as switching from general anesthesia to spinal blocks or epidurals so Mom could be awake during delivery and allowing the fathers or other support partners to be in the room to experience the birth process, said Margaret Craig, division director of obstetric anesthesiology for the Parkland Health and Hospital System.

“It’s just a progression to make having a C-section as natural a process as having a vaginal delivery,” Craig said.

Parkland also works to allow moms to hold their babies who are delivered by C-section as soon as possible, and some nurses also encourage the mother to nurse the baby while she is still on the operating table, Craig said.

JPS Health Network officials say they are “in the process of evaluating the various components of gentle C-section, and plan to incorporate elements that we determine would be beneficial and safe for our patients, both mothers and newborns.”

In January, for example, the hospital began keeping moms and babies together from the time of birth — at Mom’s bedside — whenever medical concerns didn’t prohibit it, said Pat Alridge, JPS Health Network nursing director.

‘It was great’

Daniela Sanders of Cleburne said she was initially worried when she learned late in her pregnancy that she would have to deliver twins Sophia and Landon by C-section because her son was breech.

But her doctor at Texas Health Harris Methodist Hospital Fort Worth told her she would immediately get to hold and kiss her babies, which Sanders said helped distract her from the surgical procedure.

“It was great. It would have been a lot more scary if they would have just taken the babies away,” she said. Sanders and her husband, Ian, welcomed their twins, who were born at 38 weeks at about 6 pounds each, on July 17.

Sanders held Landon first for a couple minutes before Sophia arrived.

“I was able to able to breastfeed Sophia right there on the operating table while they were stitching me up,” Sanders said. “Everything went well.”

For Hilary Pearson, the immediate skin-to-skin contact with Truman made his birth seem more natural and less surgical.

“The biggest difference will be what I remember from it. Sadly, what I will remember from Rosie was that it all occurred so quickly,” Pearson said.

“What I will remember from Truman is that it felt much more relaxed. I got to hold him right away. It will remembered as a different sort of experience all together.”

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