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.)