In more and more Dutch hospitals it is possible to opt for a natural caesarean section. This is also called ‘gentle section’, ‘natural caesarean’ or ‘mother/child-friendly caesarean section’. With a natural caesarean section, the parents are more involved in the procedure than with a normal caesarean section. This gives them the opportunity to experience the birth of their child more consciously. Mother and child are also not separated after birth, unlike a normal caesarean section. This is better for parent-child bonding and the initiation of breastfeeding. Moreover, a mother experiences less stress during a natural caesarean section and her recovery is faster afterwards.
History of natural caesarean section
The natural caesarean section was invented and developed by the English gynecologist and professor Nicholas Fisk at Queen Charlottes and Chelsea Hospital. Fisk saw that everything was being done to involve parents in a natural birth. And he thought it was strange that, with a caesarean section, no thought was given to how the birth could be made as pleasant as possible for the parents. And yet many mothers suffered from the fact that they could not consciously experience the birth during a caesarean section.
In the Netherlands, the natural caesarean section was introduced by Sicco Scherjon at the Sint Lucas Hospital in Amsterdam. A patient who had heard about Fisk’s natural caesarean asked if she could also have a natural caesarean section. After consultation with his team, Scherjon decided to do this. It turned out to be a wonderful experience for both parents and staff. And this while little more was required compared to a normal caesarean section, except a larger medical team. In 2013, Sint Lucas Hospital introduced the natural caesarean section as standard policy. News about the natural caesarean section spread quickly through acquaintances of the patient and the internet. Many other women also wanted this and presented it to their gynecologist. And so the natural caesarean section was introduced in more and more hospitals. In 2014, it was already possible to opt for a gentle section at half of the Dutch hospitals with an obstetrics department.
Choosing the natural caesarean section
In some countries, mothers are allowed to choose between a natural birth and a caesarean section. But in the Netherlands, a caesarean section is only performed if there is a medical need for it.
A natural caesarean section is only possible with a planned caesarean section. This is because a gentle section requires a larger medical team than a normal caesarean section. In the case of an emergency caesarean section, it is usually not possible to get the entire team of gynecologist, anesthetist, pediatrician, obstetrician and nurses together in time. In a caesarean section, the baby is delivered through an operation through the abdominal wall. Most babies are born within fifteen minutes of the start of the operation. The gynecologist then stitches the uterus and abdominal wall closed again. In total, the operation usually takes 45 minutes. Such an operation is never completely natural. But with a natural caesarean section, a natural birth is simulated as much as possible. Hence the name natural caesarean section.
How does a natural caesarean section work?
Relaxed atmosphere
If parents opt for a natural caesarean section, the entire process is clearly explained in advance. How exactly the procedure works may differ per hospital. But the main principles of the natural caesarean section are the same at most hospitals.
During a natural caesarean section, the operating room creates the most relaxed atmosphere possible. For example, parents may bring background music and have it played during the operation. And when the baby’s head is born, the lights are dimmed (except for the operating light). A higher temperature than usual is also ensured in the operating room: 22 instead of 18 degrees Celsius. This means that the baby does not easily become hypothermic after birth.
Consciously experiencing the birth and seeing it happen
During a natural caesarean section, the partner may be present. The mother receives an epidural instead of anesthesia, so that she can also experience the birth consciously. Moreover, the parents can watch once the head is born, if they wish. This can be done using a transparent cloth or by lowering the surgical cloth. In this way, parent-child bonding can begin during birth.
Walking the baby out
With a natural caesarean section, the baby is removed from the abdomen more slowly than with a normal caesarean section. This is called walking the baby out. The pace of a natural birth is imitated as closely as possible. This causes the baby’s lungs to open better. The umbilical cord must also be tied off and cut until it has been exhausted. This improves blood circulation and gives the baby a better start.
Mother and baby are not separated
During a normal caesarean section, the baby is immediately taken by a doctor to be examined. In addition, the baby must remain in the maternity ward when the mother is in the operating room. As a result, the mother can only hold her baby for half an hour to an hour after a normal caesarean section. Usually it has already been washed and dressed. As a result, many mothers feel that they have not consciously experienced the birth. But after a natural caesarean section, the newborn baby remains with the mother as much as possible, just like after a natural birth. This is good for bonding between mother and child and for initiating breastfeeding.
Immediately after the baby is born, the nurse places it naked on the mother’s chest. This allows mother and baby to have skin-to-skin contact immediately after birth. Just like after a natural birth. This is possible because during a natural caesarean section the ECG plates are placed on the mother’s shoulders, instead of on her chest. Of course, this only happens if the pediatrician present during the operation determines that the baby is in good condition. A check that only takes about 2 minutes. The baby also remains with the mother during the suturing of the surgical wound and in the recovery room.
The benefits of direct skin-to-skin contact after birth
Direct skin-to-skin contact after birth is very good for stabilizing the baby’s temperature, breathing and heart rate. The baby also comes into contact with the mother’s skin bacteria in this way. Furthermore, babies who are placed with their mother immediately after birth have higher blood sugar levels. Moreover, breastfeeding is more likely to be successful if the baby is placed directly with the mother. If the mother chooses to breastfeed, she will be helped to latch her baby as soon as possible after delivery. Just like after a natural birth. Furthermore, the mother feels less pain if she can hold her baby directly.
