The Myth of the Gentle C-section

           Gentle C-section


All women everywhere, no matter how they birth, should be treated with respect and care.

I think that this — respectful, gentle birth care — is probably something that every birth advocate wants for women.  That is why we are in this business, why we work hard to do what we do.  And so, when somebody pitched the idea of a “gentle cesarean” it sounded pretty good.

I first heard of the gentle cesarean a few years ago.  There was a video being passed around the Internet about this revolutionary practice.  People were excited, and rightly so.  But I have to admit, from the first time I heard of the gentle c-section, it made me nervous.

Call me a cynic, but it seems to me that obstetrics has a long and dirty history of making birth less natural and calling it an improvement, of making birth more dangerous and calling it lifesaving, and of basically doing things not because they are better for women or babies but because they make money.

A recent article out of Dallas Texas claims that more women are “opting” for these gentle cesareans.  It is great that this is being offered, talked about and done.  There are however a few problems with the hype around the gentle cesarean.  Here are two important reasons we should all be a little worried.

1)  There is no such thing as a gentle cesarean

Cesarean birth, no matter how well the mother is treated is by no means “gentle”.

Cesarean is surgical birth.  It is lifesaving if done when necessary, but even then it is major abdominal surgery, cutting through layers of tissue and birthing a baby in a manner which exposes the mother and baby to some considerable risk.

Cesarean is not “gentle”.

Personally I would prefer we use the term “mother-friendly cesarean” as talked about on “Banned From Baby Showers”.  (Check out the link for a beautiful “mother-friendly” cesarean by Ceci Jane.)  The term “mother-friendly” is more accurate because this type of cesarean, while still physically similar and involving major surgery DOES respect the mother and her need for gentle care and her babies need for immediate contact.  Ideally ALL cesareans (when possible) should be “mother-friendly” despite the fact that we can’t magically make abdominal surgery “gentle” just by wanting it to be so.

2)  The marketing of the “gentle cesarean” could potentially RAISE c-section rates

I think natural birth is fabulous and I routinely seek to share my passion for it with others.  But I — the woman who squatted out her baby in her TV room — am a weirdo.  The very thought of doing such a thing makes most women cringe.

Most people are a little frightened of birth and the pain that is often part of it.  They would like nothing more than to avoid the stress and yuckiness of vaginal birth but have the benefits of straightforward vaginal (or even home birth) such as immediate skin to skin or delayed cord clamping.

In my darkest place, I have to admit that I fear the coining of the term “gentle cesarean” is not much more than a marketing ploy.  What would be better than to literally “sell” more c-sections by making them more appealing and more “gentle” sounding?  This is a genius plan on the part of those who make a lot more money off of the cesarean epidemic.  What is better than the money you can make off a c-section combined with practices that keep those clients happy too?

I foresee a future with more women “requesting” these gentle c-sections not because they need them, but because they are afraid of birth and feel as though they have found a way to have their cake and eat it too.  I can see their providers encouraging these surgeries even for women who don’t need them. I foresee a future when doctors who practice “gentle cesarean” have full offices, busy practices, and nice cars.  (And 100% c-section rates.)

In fact, the article out of Texas even quotes a doctor talking about these surgeries being as natural as the natural births they see. I hope that cesarean birth can be as beautiful as an empowering natural birth, but there is no way it is as natural — unless the way women are being delivered of their vaginally-birthed babies in these hospitals is overly brutal and forced.

In the end I am of course GLAD that this option is available. I talk to all my natural birth students about the possibility of cesarean section and encourage them to talk to their provider and see if they can have access to this option if needed.


The most important thing is that mothers and babies are safe and also happy with their healthy birth. If a cesarean needs to be done, it should always be performed in the kindest and most respectful way possible. The women of the world and their children DESERVE better births no matter what kind of birth they must or choose to have.


Still — we need to be cautious. There are countries where hospital births have c-section rates well over 50%. Is that something we really want in America and around the world? Will the marketing of a supposed “gentle” cesarean serve to simply increase the appeal and accessibility of the already overly-prevalent c-section? Even if this is something women want, should we do it at the risk of their lives, their fertility, and the possible damage to their babies that we know c-section brings no matter how gentle?


There is a distinct possibility that we will see this wonderful thing (the mother-friendly cesarean) be overused just as we have seen the overuse of other harmful obstetric practices. We owe women and babies better than that.


About Sarah Clark

Sarah Clark is a mother of four and a natural childbirth educator in Sonoma County.  She blogs at Mama Birth and works as a natural birth teacher trainer for Birth Boot Camp (online and in-person natural birth classes.)

9 thoughts on “The Myth of the Gentle C-section”

  1. As someone who had a homebirth that ended in a hospital cesarean, I would’ve longed for a gentle cesarean. Is it that you are troubled by the term or the concept itself? I can see wanting the term to be “mother-centered.” My cesarean was anything but, I can assure you.

    As for wishing hospitals would make cesareans more humane, YES PLEASE. Mine did not have to be the emotionally and physically violent affair that it was, any more than a vaginal birth has to be a physically or emotionally violent affair. (I’d like to mention that not all vaginal births are gentle either- like a cesarean, which is major surgery as you rightly point out- it can also be a difficult eviscerating experience).

    I also hesitate to say that by doing this, more women will want cesareans. What if a woman knows all her options and just really wants a cesarean? I know we’re mostly natural birth advocates here, but after a woman is completely educated, it’s not my place to tell her what birth to choose. I’ve had friends who have fears of childbirth based in histories of sexual assault. They all chose elective cesareans, had what they experienced as empowering, beautiful births, and I say more power to them.

    I get being suspicious of this, but I want us very much to still make room for women to choose the birth that is best for them and their families.

  2. I started my pregnancy completlt wanting a hospital experience. After getting a midwife, and reading Hypno-Birthing – I changed to a home water birth. I was fully prepared. Then, the baby turned breech. In ambulance, the nutty adventure began. While I’m glad that the hospital is prepared for emergency and that is really all they’re good for these days, the brashness and debate that took place in the first hour there, cannot be understated. The staff are largely unprepared for an educated birthing woman – me. I fought everything, because their goal was to immediately jump in to save the baby. He was fine. After all the epidurals (against our wishes), the pitocin (against our wishes), the IVs, my immobolization, hunger (no food for over 30 hours), our beautiful baby boy was born by C-section. It was not gentle. The OB/GYNs did not speak to my midwife who stayed in the OR, they spoke only to each other, and when the severe body shakes and chills from the epidural took over (which the anes. Doc could not explain why) – I had to go within. I heard a baby cry in the distance. After 30 minutes, I finally saw him. The suction sounds from the surgery drowned him out. The main OB doc left me with the student doc to finish me up. Everything was rushed. Now, I did recover from the surgery – I had severe leg swelling, and vomitting the next few days. The hospital food was atrocious. And my midwife ended up walking away from the in-hospital lactation consultant because she was too aggressive. Baby was wonderful. Breastfeeding took lots of effort, but I was seriously determined, and 2.2 years later, is still going strong.

  3. I hope I don’t sound rude, but I find myself really bristling at these words and have to agree with Partaria. If there are women on this planet who feel like c-section is an acceptable way for them to birth, then they should be able to make that choice for themselves whether or not it adds to our country’s cesarean rate. It’s no one else’s business. What needs to be addressed is the doctors and hospitals who are bullying and pushing women into cesarean when they would prefer otherwise.

    Let me tell you something. I believe in natural birth. I would have preferred the “yuckiness of vaginal birth” over the massacre made of my body in the OR any day of the week. I knew I didn’t want cesarean. I fought through labor for 4 days with the goal of homebirth because I believed in it so bad. Instead, I got wheeled into an OR where my baby was ripped out of me and tossed around by strangers. I didn’t hold him for an hour. Two years later I still cry when I watch his birth video and see him startled and scared every time the nurses touched him. My heart aches hearing him cry for his mother’s arms while I was helpless on that table because I didn’t know I could demand gentle cesarean measures. When I birthed his sister 15 months later, I fought like hell for VBAC. When she was in danger and we needed repeat cesarean, I fought even harder for that gentle cesarean. You’re absolutely right – it’s in no way gentle on a mother. I was still tugged, manhandled, bruised, swollen, and scarred. Months later my nerves are still dead and I still feel pain along my incision site. “Gentle” cesarean isn’t about mom making a spa day out of childbirth – it’s about making birth gentle and loving for her baby. Mine was in my arms within 30 seconds and stayed there for the rest of the day. She was safe and secure despite a less than ideal mode of birth, just like every baby deserves to be.

    1. Thank you for your comment. I am a first time mom expecting twin boys and I have been reading mothering magazine since I was about 7 thanks to my amazing mother who always had it in the house; we were both devastated when it was no longer in print. To learn that I would be denied even the option of a delivery at a birthing center with midwives because they cannot work with twins was difficult but I am young, strong and healthy and was sure I would at least get to have a natural, vaginal delivery. After a stellar pregnancy without a moment of morning sickness and making it to 35 weeks with twins and still working, cooking, going for walks and doing all sorts of things people said I wouldn’t be able to do – I still may HAVE to have a c-section. Not only are the boys still completely transverse, but there are some developing health issues that may make it necessary to get them out sooner rather than later for the health and safety of all three of us. I am staunchly in favor of natural childbirth, but c-sections exist to keep us safe in difficult circumstances and if true medical reasons dictate that we must, you better be sure I will do whatever will keep myself and my babies safe. And yet I am going through a deep grieving process at the thought of not being a part of my birth and a panic at the thought of being separated from my babies in those first crucial hours. Finding the concept of a gentle c-section has been a sudden ray of hope that has made me feel like I can breathe again, like I could survive having to have a c-section. Like cyclamen said, this is about creating the best birth and bonding I can for my babies – not about making things easier for me. There are so many who want and strive for a natural birth and when emergency necessitates a c-section they feel so robbed of the experience that they often feel undeserving of the word birth. If there is something that can make these women a part of their birth, and promote less trauma and earlier bonding and contact with the babies then I cannot fathom why anyone (namely this author) would be so opposed to it just because you (again, the author) think it might make people want to have c-sections more. If you got to have the birthing experience you wanted then you are very fortunate, but don’t disparage something that might improve what will no doubt be a traumatic experience for me.

  4. I suspect that anyone who is aware of the term ‘gentle caesarean’ is well versed in birth matters. While planning the – ultimately unassisted – home birth of my 14-month-old son, I had little reason to fear a difficult birth – he would be my third vaginal delivery and the last labour had taken 3 1/2 hours. Nevertheless, I had a real fear of a caesarean and I felt compelled to face it.

    Remember that many women come to the natural birth community from a history of past abuse and birth rape. The fear of no longer being in control of one’s body is huge and very real, and there is nothing more threatening than being strapped down and anaesthetised for a c-section. So, I made a plan. I’m under no illusion that c-sections are easy, and I would have been devastated had my birth ended this way, but I still wanted to feel as though I had a back up plan. My son’s birth was easy and uncomplicated, and I pushed him out, nuchal hand and all, in three hours of labour. I still don’t regret making a c-section plan – as long as I’m still talking and breathing, I am in control of my body and I should have a say in what happens to me and my baby. I think you may be underestimating the women who are likely to be interested in the concept of a ‘gentle’ c-section – they’re likely the same ones who know full well that c-sections are not an easy option.

  5. My daughter Joy was born at 23 weeks last year. Due to modern medicine and prayers she is doing great today. I hemorrhaged at 17 weeks for the first of 4 times because of 100% placenta previa, which turned into placenta accreta (which I believe was caused by 3 prior c-sections). After she came home from 121 days in the NICU, I wrote a memoir called “From Hope To Joy” about my life-threatening pregnancy and my daughter’s 4 months in the NICU (with my 3 young sons at home), which will be published in the beginning of August. It was quite a roller coaster that I am certain some of you have been on or are currently riding on. My goal of writing our memoir is to give a realistic look at what lies ahead to families with preemies in the NICU while showing them that hope can turn into Joy and that miracles can happen. I also want to make sure woman are educated about the dangers elective c-sections can have on future pregnancies.
    Please let me know if this is the appropriate place to post some messages about our memoir and please offer any suggestions as to what else I can do to spread my message. I appreciate any and all advice.
    Please see my website:
    and subscribe.

  6. I do not come here often – I am one of “those mothers” that many of you have a disdain for – the mythical, Cesarean by Choice mom.

  7. I suppose i see the point you are trying to make, but by your logic, ‘mother centered’ can just as easily be used as a marketing ploy as ‘gentle’. The reality is, lots of women have c sections in the US, either by choice, out of ignorance, or through necessity. I feel that this push for gentle/mother centered/whatever sections is positive in every possible way. It is a concept that is more inclusive of the mother in the process regardless of how you swing it. it is presenting the idea of choice where often there seems to be none, and it is pushing doctors to be more aware of the mother as a mother and not just a patient.
    I had a gentle c section. I in no way hesitate to use the phrase. It was also an emergency.
    I was 38.3 weeks with twin boys, my first, and had a wonderful OB willing to wait it out with me to 40 weeks and deliver vaginally despite baby A being transverse and B being frank breech so far as we could tell, and both estimated over 8 pounds.
    My body had other plans and over a 24 hour period my BP went from 130s/90s to 150s/130s. We decided we needed to get these boys out ASAP. My doctor informed me of all the available alternatives to what I had originally planned for in my desired un medicated vaginal delivery.
    He would ‘milk’ the cord, as delayed clamping wasn’t much of an option
    We would do ‘seeding’
    He would convince the anesthesiologist that both my mom and husband needed to be in the room and the boys would be handed immediately to them for skin to skin and would be latched on to breastfeed as soon as the incision was closed.
    My boys didn’t cry, weren’t manhandled or violently suctioned, and came into recovery on the gurney with me.
    The doctor was a gentle and cautious as possible with incision and closure and assured me there should be zero issues with future vaginal deliveries. my recovery was quick and relatively comfortable and my boys never left my sight.
    It was absolutely a more gentle option that i thought possible with such a procedure, having witnessed my sisters c section, the roughness with which she and baby were handled, the total disregard for her presence etc.

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