Tuesday, July 5

Changing labor with natural cesarean section

A mother and her partner are excited and relieved to witness the birth of their son, who has just been born and rests in the mother’s arms, skin to skin and about to start breastfeeding. It is an expected image of birth for many women that has in all probability transferred us to a natural vaginal delivery.

But in certain cases this is not possible for various reasons and some women have to go through a cesarean section. A surgical intervention for which, according to the report Perinatal care in Spain: analysis of physical and human resources, activity and quality of hospital services, Of all the births attended in Spain in 2018, 21.8% of the women passed, about seven points above the maximum stipulated by the World Health Organization (WHO).

Something that is already changing because there is increasing interest in making childbirth a more natural and humanized experience, even if it is through a cesarean section. But is it possible that a cesarean section is more respectful of the needs of the baby and the mother?

Thanks to the drive and interest in achieving increasingly respectful deliveries, the image with which we began the article can also be associated, in certain respects, with a new, different type of cesarean section: the natural cesarean section.

Making a cesarean section more than just a surgical procedure

A natural C-section is a procedure that makes a C-section look less like an abdominal operation and a bit more like a vaginal delivery. The surgical aspect is the same: the woman is numb from the waist down, the doctor makes an incision through the abdomen and uterus, and after a few moments, the baby is born. The big difference is that with a natural caesarean section the woman and her partner can see and touch the baby.

It is intended to put parents at the center of the birth so that they can witness the birth of their baby and enjoy skin-to-skin contact right away. It allows, therefore, to incorporate the most natural aspects of childbirth, such as being able to witness the moment when the head is raised, hold it immediately, start breastfeeding and keep the mother and the baby together even if the operation has not finished.

In a normal cesarean section, early skin-to-skin contact and initiation of breastfeeding within the 30 minutes recommended by the WHO / UNICEF Friends of the Child Initiative are almost nonexistent.

But with natural caesarean section, the mother can see her baby being born and labor is slower – the way the baby is delivered is slower to more closely mimic what a normal birth would look like. Usually, the cord is cut very quickly in a conventional cesarean section, but in a natural one the cut is delayed to allow all the fetal blood to move into the baby’s body, an important factor for oxygenation and iron stores.

“We incorporate the good practices learned from vaginal birth to cesarean delivery”, acknowledges Dr. Manuel Duárez Coronado, specialist of the Obstetrics and Gynecology Service of the Jiménez Díaz Foundation University Hospital, a center that, in its efforts to humanize health care in all scopes, bet on natural cesarean section as a safe and beneficial option.

During the cesarean section, “the mother is more stable from the hemodynamic point of view, which favors the puerperium, reduces intra and postoperative pain and makes the uterus contract more easily”, admits Duárez.

Something that mothers like Mariana can already explain, who has just given birth to her second child by natural cesarean section. “It has been spectacular, very exciting,” says Mariana.

When is a natural cesarean section performed?

Natural C-sections are not a substitute for a vaginal delivery. Only when this is not possible, because for medical reasons it is contraindicated, because the cesarean section has to be scheduled, the dilation process does not progress adequately or due to an obstetric emergency, a cesarean section is chosen.

According to the World Health Organization (WHO), 10-15% of births have medical complications requiring a cesarean section. And, like Mariana, mothers can benefit from this option as long as the medical team values ​​it positively.

The natural caesarean section is intended to be a way to improve the surgical experience and its goal is to improve caesarean sections for women who have to undergo one.

Ten years ago, the Obstetrics and Gynecology Service of the Madrid hospital began the first steps to optimize the humanization of childbirth. During all these years they have allowed the monitoring of the pregnant woman in the case of conventional cesarean section.