Family-Centered Cesarean Birth

A cesarean section is more than an operation. It is the birth of a baby. The way a father and mother feel about their childbirth experience may affect their ability to bond with their newborn. Seeing, touching, and comforting the baby immediately after birth begins the bonding process that is so important to the fostering of maternal and paternal feelings. Therefore, many cesarean couples desire to share in the miracle of birth just as they would if it were a vaginal delivery. George Nolan, MD, of Women’s Hospital, University of Michigan Hospital, reported in “Family Centered Cesarean Maternity Care Policy” that 100 percent of parents who attended the cesarean births of their babies indicated that they would prefer being together for future cesarean births. He also noted that 50 percent of parents separated at the time of cesarean delivery expressed a desire to be together for future cesarean births.

Many fathers wish to participate in the cesarean delivery of their children to comfort and support their partners and also to witness the birth. Most hospitals permit labor partners to attend cesarean deliveries as long as regional anesthetics are used. If general anesthesia is necessary, couples need prior permission from the obstetrician and anesthesiologist. Some doctors feel that the labor partner does not need to be present when general anesthesia is used because the woman is asleep and unaware of any emotional support. They also fear that the woman’s unconscious appearance may be upsetting to the labor partner. If you would like your labor partner to be present while you are under general anesthesia so that he can later describe the birth to you, talk to your doctor. If a true emergency exists, however, this option may not be available. Also, if more than one support person is present during labor, only one may be allowed to attend the cesarean because of space limitations.

A cesarean couple needs to find a pediatrician who is flexible and open to their desires. They should discuss with him their wish to touch, hold, and breastfeed their newborn as soon as possible, even in the delivery room or recovery room, if the baby’s condition is good. Of course, if complications arise and the baby needs special care, even the most flexible pediatrician will delay bonding and breastfeeding.

If you give birth by cesarean, ask your pediatrician to evaluate your baby as an individual and, if the baby’s condition is good, to admit him to the regular newborn nursery instead of to the special care nursery. This will allow you contact with your baby sooner.

During the birth of a baby, whether the birth is vaginal or by cesarean, a couple needs each other’s emotional support. Some couples experience an emotional climax at the moment of birth—a feeling that should be shared. During a cesarean delivery, your partner can hold your hand, wipe your forehead, and talk to you. His emotional support can be invaluable. Your attitude may become so much more positive that you relax better and recover faster. Many fathers like to take photographs or videos during and after the cesarean delivery. Your partner may even be able to take his equipment into the nursery to film the baby’s admission bath and procedures. This is a good opportunity to record the events that you are unable to view.

Couples who are not allowed to share in a cesarean birth may instead end up sharing feelings of resentment and disappointment. It is even more necessary for a couple such as this to bond with their baby as soon as possible and to talk to each other about their feelings.

Another option that should not be affected by the method of delivery is rooming-in. With help from her labor partner, a cesarean mother can enjoy all the benefits of having her baby with her. For the first 1 or 2 days, however, she may wish to delay rooming-in, or to limit it to times when help is available. If she is in a private room, her partner can have unlimited visitation and provide the needed assistance, day and night.

If the possibility exists that you will be delivering by cesarean, you need to participate actively with your doctor, anesthesiologist, and pediatrician in planning your birth. You should have your partner join you for several of your doctor’s appointments and talk with him about the surgery, anesthesia, and postpartum period to make sure he knows your desires. Do not take anything for granted or you may be disappointed. Your requests, of course, must be reasonable because a cesarean section is major surgery and involves risks to you and your baby. However, having a doctor who strongly believes in the benefits of family-centered maternity care will increase your chances of having the type of birth you desire.

Another good source of help is your local cesarean support group. The members of a group such as this can give you additional emotional support after your birth. Many cesarean mothers find it helpful to talk to someone else who had a c-section and who knows what the mother is going through.