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Cesarean Section, Gentle Cesarean, Natural Cesarean and Cesarean Massage: An Overview

Cesarean Section, Gentle Cesarean, Natural Cesarean and Cesarean Massage: An Overview

Cesarean Section, Gentle Cesarean, Natural Cesarean and Cesarean Massage: An Overview

Cesarean section is not something that one might describe as “lovely” or “gentle”. It is a major operation and should be understood as such.

Some women are forced to have their children brought into the world in this way, whilst others see it as a viable alternative to ‘natural’ birth. Whatever the background, the final outcome is the same: A cesarean section and it’s important to know what options are available within this term, how parents can lay a good foundation for a positive bonding experience with their babies and how mother and baby can make an optimal recovery.

Cesarean section

Abdominal delivery or cesarean section is a medical intervention that means the baby or babies are physically removed from the womb via an operation. The mother is given spinal or epidural anesthesia or general anesthetic, depending on the situation, her wishes and the outcome of any consultation. This means that the pregnant woman feels no pain for the duration of the surgery, which usually lasts around an hour. If a local anesthetic is used, the mother is awake and can feel the movement of the surgery, though not pain. (There are some cases in which anesthetic was used too early/late and the women concerned had unbearable pain).

During the surgery, a screen is erected between the mother and the surgical team so that she and her partner cannot see any details. A good team informs the mother with each step regarding what is happening and they try to ensure that they are sensitive to the mother’s reactions.

As soon as the baby is born, he or she is taken away by a midwife or pediatrician to be examined or in the best case, is laid directly onto the bare chest of the mother, in order to start the bonding process.

What is the difference between primary and secondary c-section?

If the birth was not induced, there were no contractions or the waters did not break, the method of delivery is classed as a primary cesarean section. The reasons for a primary c-section might be a sick mother or child or the position of the baby (e.g. breech) but also the increasingly-popular elective cesarean. Here, the mother decides, following extensive advice and information that the baby will be born in this way on a date agreed with doctors.

A secondary cesarean section happens when the birth of the baby is already underway, effective contractions have started, waters have broken and suddenly complications arise that make a c-section necessary. For example, the baby’s heart rate rapidly decreases or the birthing mother fails to progress in labour.

The “gentle” cesarean

This choice of words is misleading, since this, similar to a ‘normal’ cesarean, involves the baby being removed from the womb surgically. Instead of opening the abdominal wall completely, the Misgav-Ladach method means only making a small incision and then carefully stretching and parting the deeper layers of tissue. This should lead to reduced bleeding and tissue damage. ‘Gentle’ means that the recovery process is quickened and associated with less pain. For the baby it is no different to a ‘normal’ c-section.

The “natural” cesarean

Also misleading in terms of choice of words: The natural cesarean according to Nick Fisk. Here too, the gentle cesarean surgical method is used but the difference is that at the point at which the baby is delivered, the parents have the possibility to see their baby come into the world, just like with a natural birth. Doctors lower the screen that usually separates the parents from the surgical team so that the birth can be observed. The baby is then put directly onto the mother’s breast, complete with umbilical cord, which the father may cut. This allows a positive bonding experience between mother and child from the very start and despite not being classical, natural birth, helps to trigger the production of happiness hormones, which in turn aid bonding. To find out more about encouraging bonding following a cesarean section, continue reading under ‘Bonding after c-section’.

This controversial type of birth is not commonplace in all clinics but is offered in Berlin’s Charité hospital, for example.

Cesarean newborn massage

At the 10th breastfeeding and lactation convention in Berlin, we learned about the cesarean newborn massage.

The motivation behind this type of massage is that babies who are born by cesarean section don’t make their way through the birth canal, meaning that external pressure through the contracting uterus, and being pushed through the birth canal is not exerted on the infant’s body. This could lead to various sensory processing disorders- i.e.because certain stimuli can’t be correctly processed, balance, motor, vision and coordination dysfunctions may occur in the child. Every baby/child might react differently to their birth experience so that the conclusion that the birth experience is behind such disorders may not be reached by parents or experts.

But how can the cesarean massage prevent or reduce sensory processing disorders (which are not an illness, as the lecturer, Frau Rothaupt emphasized)?

Through a pressure massage, done in several sessions, first by an expert and then by parents, the pressure usually experienced in the birth canal is exerted upon the child. From the head to the shoulders and upper extremities, the ribcage and stomach, over the buttocks to the lower extremities- all regions of the body are gently pressed with the hands. During one session this is done up to 3 times consecutively. It was exciting to see in a video that was shown during the seminar, how the baby relaxed when receiving pressure to the head but seemed very grumpy when pressure was put on his shoulders. At the end of the pressure massage, the child is stroked from head to toe. Once they have received instructions, parents can replicate this massage at home if they feel confident in doing so. It’s well known that massage supports parent-child bonding and is generally recommended. In using the cesarean massage on newborns (also on older children), sensory processing disorder can be reduced, and parents and children can bond. We think that can only be a good thing.

Bonding after cesarean section

Many parents worry about bonding following a cesarean. These worries are based on the fact that the baby often doesn’t have direct skin contact with the mother following the birth, because, for example, complications mean he or she needs to be taken to the NICU etc. It’s now known that it’s possible to catch up on bonding in the hours, days and even weeks following birth through appropriate methods such as Brigitte Meissner’s Bonding Bath or the kangaroo method.

A variant we would also like to show you is the Bonding Top or Sectio Top or also Kangaroo Wrap. This elastic wrap can be put over the upper body of the mother before the operation. As soon as the baby is born, it is placed under the wrap, directly on the mother’s skin so that first contact can be established. In this way, the newborn is held in position with moderate pressure, the baby is relaxed since he or she can lie in a familiarly narrow space, is kept warm and has direct skin contact with the mother. The wraps are available in many different colours and sizes and can also be used for multiple babies. If your child needs to spend a longer time in the hospital, the top can be used for kangarooing, giving you the closeness that your family needs.

modell_01These are available to buy from e.g. didymos and hoppediz:

http://www.didymos.de/out/jagcms4oxid/oxbaseshop/Neonatologie/Kaenguruflyer.pdf

Do you have experience of a natural c-section, cesarean massage for newborns or a bonding top? We would love to hear about your experience!

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