Maternal-Assisted Cesarean Section: What You Should Know

When you imagine the moments after birth, imagine a baby being placed on the mother’s chest. Occasionally, birthing mothers even reach down and grab their babies themselves, as Kourtney Kardashian famously did when she gave birth to her daughter Penelope in 2012.

“I remember always seeing scenes of women giving birth and being scared. So when I had my birth experience and it was so incredible and amazing, I just remember wanting to share that to help other women maybe not be afraid or have that perspective.” Kardashian Variety said last year when I reflected on the experience that aired on Keeping Up with the Kardashians.

Even in the pure reality genre, the images of Kardashian catching her babies were unusual. We’re not used to seeing a real newborn that emerges covered in blood and waxy vernix. We are also not used to a mother taking an active part in her own birth in this way.

When we hear about a person giving birth to their own baby, sometimes it’s because they were born accidentally in a car or perhaps as part of a planned home birth.

But what if such an experience were made available to more birthing women, even those who deliver by cesarean section – how? almost a third (32.2%) do? The idea of ​​a woman participating in her own surgery may sound far-fetched, but advocates of the practice known as a maternally assisted cesarean section say it is not only possible, but also for the mothers who choose it. is advantageous.

A mother-assisted C-section involves the same instinctive movement that Kardashian used in her deliveries, except instead of the woman reaching between her legs to lift the baby to her chest, she reaches toward the incision in her lower abdomen. (Note that they are not reached into it (The incision does not occur, but grasps the baby after a doctor removes the head and shoulders.)

This changes the appearance of the operation, primarily by removing the sheet that generally separates the patient’s head and chest from the lower half of the body. Not only does she lift her baby to her breast, but she also has a complete overview of the operation itself.

This means that a woman enters the office with her doctor, thoroughly washes her hands and forearms with a nail brush, and then puts on a pair of sterile surgical gloves to wear when reaching for her baby. Because such preparations are necessary to prevent the risk of infection, only planned cesarean sections, not emergency cesarean sections, can be supported by the mother. (Note that “emergency” here means that the C-section was unplanned, not necessarily that someone’s life was in danger.)

C-sections with maternal assistance are not common, and not all doctors are willing to participate in a C-section. However, women who have had a cesarean section of this type say that the opportunity to take an active role in the delivery made all the discussion, planning and preparation worth it.

For a woman who hopes to have a vaginal birth and has some level of control over her birth experience, the realization that she needs a cesarean section can lead to frustration or disappointment. Choosing a maternally assisted cesarean section can make the birth experience more satisfying and meaningful for some mothers.

““I had a vaginal delivery with my first birth and a cesarean birth with my second birth,” Lyz Evans, an Australian physical therapist (the term “physiotherapist” is more common in the U.S.) told HuffPost.

Evans, co-founder of an exercise program called Empowered motherhoodShe used the words “clinical” and “disjointed” to describe her first experience with a cesarean section. “They are numb from the chest down, lying flat on their back and separated from the birth team and the operation by a sheet,” she said.

However, in a maternally assisted cesarean section, “the cloth is removed so you can observe the procedure, and because you are able to reach down and pull your baby out of your stomach yourself, you feel like you are really in the womb “Being involved in the process” and that can be so powerful and incredible,” Evans said.

Evans had first heard about maternally assisted cesarean sections on South American social media and wondered why the procedure wasn’t being offered more widely. As she prepared for her third birth, she thought about this option and how it would help her take an “active role.”

The hard part, she said, was convincing her doctor, who had never performed a C-section this way before, to do the procedure and convincing the hospital to allow it.

The biggest safety risk is “the risk of contamination of the sterile area where the surgery takes place,” said Dr. Josie Urbina, a gynecologist at the University of California, San Francisco, told HuffPost. Urbina performs traditional C-sections and explains that “patients typically sit behind a non-sterile curtain, accompanied by their partners, doulas, and the anesthesia team.”

Removing the curtain so the patient can reach for her baby would make it difficult to maintain a sterile surgical field, Urbina said. The team would have to get creative: “If there is a way to make the patient sterile to help her deliver her baby, then that can reduce the risk of contamination and therefore the risk of subsequent infection of her incision and/or her Reduce uterus.” Cesarean section.”

Infection, she said, would “delay wound healing” and cause increased pain. Such infections can also become serious.

The procedure is only possible for planned cesarean sections and high-risk pregnancies. Your doctor must consider your individual risk before agreeing to carry out the operation.

Despite these risks and caveats, the procedure offers advantages. One of these, says Urbina, “is helping to ensure that the patient feels involved and in control of their own birth experience.”

“Helping a patient deliver her own baby via cesarean section can be a very satisfying and memorable experience for someone who originally envisioned a vaginal birth,” she said.

Evans says her doctor, Lynn Townsend, researched the procedure, considered the risks and agreed to perform the surgery. She then fought for Evans with hospital management and ultimately secured their approval to perform the operation.

In the weeks leading up to the birth, Evans said she and Townsend “discussed the logistics of birth and the importance of ensuring a sterile environment and practiced the steps involved.”

This included having Evans undergo a surgical hand wash and donning a gown and sterile gloves while lying on her back.

““We rehearsed the timing at which I would reach down to deliver my baby from the womb and the speed at which I would lift him to my breast to ensure Dr. “Townsend had enough time to check that the umbilical cord was of sufficient length,” said Evans.

In addition to discussing the usual risks of a C-section, Townsend also explained to Evans that if the baby was in distress or went into labor spontaneously, they would not be able to go through with their plan.

None of these scenarios came to pass, and when the day of the scheduled C-section came, Evans experienced something very different than her previous births.

“Compared to my first c-section, it felt much less clinical and I felt much more connected to the procedure and everyone else in the room. I was informed every step of the way, which really helped me feel like part of the team,” she said.

“I had watched every step of the operation, and when I reached the point where I reached down to lift her out, I was so emotional from the preparation to that moment. “She cried as soon as she came out of the womb and as soon as I placed her on my chest over my beating heart, she instantly calmed down like magic,” Evans said.

Evans noted that the immediate skin-to-skin contact she described can also occur during a normal C-section and that patients should ask their doctors about this possibility. More and more hospitals are now offering this option.

“It was one of the most incredible moments of my life and it was worth it,” she said.