10 Tips for a Family-Centered Cesarean Birth Plan

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When preparing for labor and delivery most moms imagine the typical vaginal delivery scenario.  We attend birthing class, create a birth plan, pack our hospital bags for a vaginal birth, and wait to go into labor. According to the Childbirth Connection, one in three mothers gives birth by cesarean section.  Planned or unplanned, a c-section is major surgery and the recovery length and process is completely different from a vaginal birth. 

In 2009, I delivered my first child via cesarean section after 18 hours of labor, 3 1/2 hours of pushing, an episiotomy, and 2 attempts at a vacuum assisted delivery.  To say my birth plan of a drug-free vaginal delivery fell apart is an understatement.  As a first time mom, I did nothing to prepare myself for the possibility of a cesarean section.  When the doctor told me that the only way my son could safely be delivered was by c-section I was shocked, scared, and very disappointed   Like any other new mom, I wanted to experience the rush of hearing my child's first cry and then holding him skin-to-skin.  Instead, right after I heard my baby's first cry he was taken to a warmer to be cleaned off, as I lay on a cold, sterile table with my arms strapped down.  There was nothing natural about my delivery.

After a successful VBAC with my second, while preparing my birth plan for baby number three I discovered the concept of a family-centered cesarean section.  Knowing a c-section could be part of my birth story I wanted to work with my medical team in creating a more natural birth experience.  With a little bit of reading and discussion with your doctor prior to going into labor, it can be part of yours, as well. 

I've compiled ten tips based on research and reading that I hope will help you, as well as me, to have a more family-centered cesarean, should the need arise. 

10 Tips for a Family-Centered Cesarean Birth Plan

  1. Inquire about bringing your own music into the operating room.  Many operating rooms have CD players.
  2. Prior to delivery, practice breathing and relaxation techniques that you can use during the procedure.
  3. Ask your doctor about hospital policies regarding taking photographs in the operating room. Many hospitals do not permit cameras or video cameras into the rooms, but this is something that is nice to know ahead of time.
  4. Ask to have at least one arm unrestrained during the procedure, so you have a free arm for skin-to-skin contact after delivery.
  5. Request that the surgery be performed slowly.  You may also want the doctors to explain the process, as it is happening.
  6. Request the screen to be lowered at the point of delivery, so you can watch your baby being born.
  7. Inquire about immediate skin-to-skin contact, as long as you and the baby are healthy.
  8. Question your doctor about the anti-nausea medications they use during the procedure.  Many of them are narcotics that cause amnesia or make you sleepy.  If possible, request non-drowsy, anti-nausea medications.
  9. Request to allow your baby to take his or her own first breaths prior to cord clamping.
  10. Request to allow you to nurse your baby and have him or her stay with you for as long as possible in the recovery room.

With preparation and an open discussion with your doctor, you can prepare yourself for a planned or unplanned cesarean section.  These more natural procedures can help make you feel more involved in the birthing process, as well as improving breastfeeding and bonding with your newborn.  

For more general information about c-sections check out the booklet What All Moms Should Know About Cesarean Sections.  


Did you have an unexpected C-section with any of your children? What was most surprising about that? What kind of birth plan do you have in place at this point, if this is your first child? Did you find this information helpful to add additional information to that plan? 

Image via Mindi Stavish

What do you think?

10 Tips for a Family-Centered Cesarean Birth Plan

Mindi is a working mom with three boys ages 4, 2, and an infant (born June 2013). She spent her first 8 years of her career in Speech-Language Pathology at a Children's Hospital. She currently works with adults and children in home health. The real fun for her happens when she is at home with her boys, chasing them around and pretending to be a super hero. She blogs about life as a working mom at Simply Stavish. Her weekly feature, Words in the Sand, teaches parents how to grow their child's s ... More

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  1. Cody says:

    Also I don’t know if any of you really want to know what takes place during the actual surgery I found out later what happened to me I was horrified! I’m going to try like heck to have a VBAC

  2. Cody says:

    I like this article but I wouldn’t get your hopes up about a lot of these suggestions. Maybe in my case it was different but I was literally the last person to see my son and didn’t get to even touch him for a couple days because we both had an infection. My birth didn’t go nearly as planned at all. Hope for the best prepare for the worst. Hope that the hospital will let you do these suggestions but it’s not likely because most recovery rooms are completely different areas than birthing areas and have people recovering from different surgeries in that room.

  3. verochka31 says:

    I have had 5 c-sections because I am small boned and don’t open up for natural delivery. really didn’t mind it, I was never strapped down. never had a bad experience. plan on doing it again for the 6th time

  4. Ashleigh says:

    I’ve had two C-sections already and am planning on my third and I wish I would have thought of some of these for the other two.

  5. Pink_Baby says:

    Some of the suggestions are possible as long as they are not posing any dangers to both mom and baby. As for your case, I think what happened was that your doctor had to stop because he couldn’t proceed with you in so much pain/pressure. This is not the same as she described above where they purposely slow down the procedure from the get-go. With you having so much discomfort, he had to stop and you probably were given pain med or narcotics that made you sleepy and probably didn’t remember anything afterward. The doctor can stop doing surgery anytime after the baby is delivered but shouldn’t delaying getting the baby out or if mom is bleeding…that was the point that I wanted to make. Thanks for your comment.

  6. Pink_Baby says:

    Thanks for your response and links to support your comments.

  7. ErinCurran says:

    Oh, and regarding doing the procedure slowly, that part I didn’t really get, nor did my OB, so we didn’t go there, however, I recently found this video by an Indian OB describing a technique he developed: http://www.youtube.com/watch?v=qT9Dynu0cRU I have no idea if it’s a good technique but I thought it was pretty interesting!

  8. ErinCurran says:

    Pink_Baby, some of the practices Mindi described as part of a Family-Centered Cesarean can and indeed are happening in hospitals around the US. In particular, skin-to-skin during surgery (#4) and dropping the drape (#6). I know because that’s what was done at the late 2011 birth of my second son!

    These ideas, along with many of the other ideas Mindi listed, were first recommended by a team of doctors and midwives in England. They described their methods for what they called a "natural caesarean" in a 2008 paper published in the British Journal of Obstetrics and Gynecology: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/pdf/bjo0115-1037.pdf. Some of the team are interviewed in this video: http://www.youtube.com/watch?v=m5RIcaK98Yg.

    Healthy Children’s Center for Breastfeeding produced a DVD called "Skin to Skin in the First Hour After Birth: Practical Advice for Staff after Vaginal and Cesarean Birth" which describes how to do it safely. Here’s a link to it (scroll down): http://www.healthychildren.cc/books2.htm#DVDs

    Dr. Susanna Magee and Dr. John Morton of Memorial Hospital of Rhode Island describe how the gentle cesarean was brought to their hosptial in a talk at an ICANN meeting. They describe the nuts and bolts of how they worked through changing protocols and addressed concerns of all members of the delivery team. http://www.youtube.com/watch?v=yhxTDxu2I_w

    Some hospitals are now promoting "gentle cesareans" as a normal course of action for non-emergency cesarean births.

    Memorial Hospital of Rhode Island: http://www.mhri.org/ss_plugins/content/content.php?content.5103
    Women & Infants Hospital (Providence, RI): http://www.womenandinfants.org/havingababy/All-You-Want.cfm
    Little Company of Mary Hospital (Evergreen Park, IL): http://www.lcmh.org/mediacenter/details.cfm?pageID=17&mediaCenterID=108
    Cape Coral Hospital (Coral Cape, FL): http://vimeo.com/41656845
    Community Memorial Hospital (Ventura, CA): http://www.cmhshealth.org/multimedia/press/2013/02-01-13.shtml
    San Francisco General Hospital: http://scienceofcaring.ucsf.edu/alumni-focus/improving-breastfeeding-success-skin-skin-contact

    Why skin-to-skin while mother is still in surgery? Because research shows that babies who are placed skin-to-skin immediately after birth have better temperature regulation, more stable blood sugar levels, cry less and have increased rates of breast-feeding. Mothers see lower rates of postpartum depression and are better attached to their babies.

    Additionally, this study showed that early skin-to-skin after c-section improves breastfeeding:

    Finally regarding space for the baby above the drape, there is room if the baby is placed horizontally across the mother’s chest.

    This is all still pretty new but I think over the coming years more and more women will ask to make these changes and hopefully more hospitals will proactively offer it.

  9. Kbenard says:

    Granted I do not remember my fiance assures me they set my 11 pound 3 ounce baby on my chest right on the operating table and allowed me to hold him also my doctor offered to STOP completely mid c-section because I was feeling so much pressure it was almost unbarable so slowing down in a non emergency c-section is clearly acceptable also I experienced amnesia and all I had was epidural and nausea meds, now being in the medical field myself I can say that could have been caused by the shock and stress of the situation. As for the delay in the clamping I don’t know a thing about that either and have no interest in delaying the clamping or cutting of the cord. Just wanted you to know that some of her suggestions are definitly possible.

  10. Kbenard says:

    This explains why I can’t remember a thing after they weighed my baby. I had to have a c-section after 18 hours of labor and my fiance says that they let me hold him and that he cut the cord and I don’t remember any of it. I remember unbarable pressure and then the baby cry and then them weighing him just a few feet away from me and then waking up in recovery with my baby next to me and them asking me if I was ready to nurse. They never took the baby away from me he went from operating room to recovery to my hospital room and stayed with me the entire 2 days I was there. However, I wish I could remember those important special moments when I got to hold him for the first time and when my fiance got to cut the cord.

  11. 🙁 I worry about having a c-section. So far everything with baby and I is normal and healthy but you never know and I’m scared to hear that I’ll have to have one.

  12. PamelaPlus3 says:

    Not very helpful but thanks anyways

  13. Pink_Baby says:

    Mindi, I am not being mean but being working in the OR helping surgeons to deliver babies and with substantial knowledge about c/section, I must say that your 10 tips are ridiculous. Let me break down some of your tips and explain why I think they are ridiculous requests for other people to follow.
    4. You can have free arm but the sterile drape is usually hang on top of your chest (very close to your face) and sometimes does not leave much chest room for your baby to have skin on skin. What possible is cheek to cheek, you can touch, kiss your baby but there is not much room for anything else.
    5. Are you crazy to request to slow down the procedure? It is unsafe to delaying getting the baby out. Most of the time, there is a window of 3 to 5 minutes to take the baby out unless there is complications. The surgeon does not have to rush if it is not emergency but he or she, in a control matter, should delivery as quick as he/she can. The doctors need to be focusing, not explaining. This discussion need to happen before your c/section.
    7. What do you mean by questioning the doctors about anti-nausea med…most of them are narcotics? Anti-nausea medications are NOT narcotics. and narcotics do not cause amnesia. Unless you are under general anesthesia as in going to sleep (which is not the case here), you’ll be receiving either spinal or epidural anesthesia and therefore, most of the time, you will not require narcotics that cause sleepiness. Most narcotics do induce sleepiness but they won’t be given to you unless you are in extreme pain and request for it.
    9. What is this about and what is the purpose for this—allow your baby to take a first breath before clamping the cord? I suggest you provide more research…do you know how the baby take his/her first breath? Do you know once the baby is delivered, what kind of placenta and blood loss complication could occur if the doctor is delaying doing what you suggest?
    I might be wrong and do not know much, but I think your tips can be dangerous.


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