"Natural" C-section?

A more "woman-centered" procedure may be in the works.


Lynn Harris
September 3, 2008 9:22PM (UTC)

As a mother of a one-and-a-half-year-old, I can safely say of childbirth that I'm in it for the baby, not for the "birth journey." I care very much about appropriate attention to maternal well-being, wise medical practice and not rushing into doctory stuff that you don't need -- but ultimately, that's about the baby, not me. Whatever it takes, within sound medical judgment, for him or her to be safe. For related reasons, when it comes to "childbirth," I have never liked the term "natural." In that pairing -- while I'm delighted for people who were happy with their own -- it seems to me to connote, even inadvertently, a false and crunchier-than-thou dichotomy, a hierarchy of desirability and experience. ("Oh you had an epidural/ had to [or, God forbid, planned to] have a C-section? Mmm. Mine was natural.")

Still, my interest was piqued when I saw (a bit belatedly) the Reuters headline "'Natural' cesarean mimics vaginal birth experience." Natural cesarean? Huh? Did someone have a C-section at home? Or, James Frey-lie style, without any painkillers?

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As it turns out, doctors in England and Australia are developing a "woman-centered" procedure for cesareans that incorporates many important aspects of vaginal birth, including parental involvement and speedy skin-to-skin contact (which in turn encourages breast-feeding). Their report appears in the current International Journal of Obstetrics and Gynecology.

"Vaginal birth has evolved markedly in the last two decades so that much greater emphasis is now given to the experience of the parents and to early bonding," researcher Nicholas M. Fisk, director of the University of Queensland Center for Clinical Research in Brisbane, Australia, told Reuters. Cesarean birth, by contrast, has remained more wham-bam, he said, focusing on speed even when nonemergency circumstances don't require it.

Specifics: Once the baby's head is delivered, the surgical area is cleaned and the birth partner (if any) can watch. The OB-GYN then slows things down so that uterine contractions can help clear the baby's lungs, "just as happens at vaginal delivery," says Fisk. Once the shoulders are eased out, "the baby then frequently delivers his/her own arms in an expansive gesture." (King of the world!) Mom can then watch the rest, after which the baby is placed directly on her chest for -- neonatally recommended -- skin-to-skin bonding.

The procedure still allows for traditional (quicker, for one thing) measures to take over if or when medically required. Fisk added that parents and hospital staffs, so far, are into the idea; more clinical trials remain necessary.

Regardless of any snobbery (again, even inadvertent) about "natural" or vaginal births, it is perfectly, well, natural for some women to hope for (drugs or no drugs) a scalpel-free, good-ol'-fashioned-pushing experience over a surgical one. Perhaps these changes could one day narrow, at least a bit, the gap between the two -- and even prove better for the baby. And Fisk and his colleagues, it should be noted, are not just talking about expanding "options" for women with the wherewithal to make a "birth plan." According to the study abstract, they are talking about full-on "reform" -- of the most common operation worldwide. Naturally, I can get behind that.


Lynn Harris

Award-winning journalist Lynn Harris is author of the comic novel "Death by Chick Lit" and co-creator of BreakupGirl.net. She also writes for the New York Times, Glamour, and many others.

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