cesarean delivery


What’s A ‘Natural Cesarean’ And How Natural Is It?

That was my reaction when I read a recent post by my friend Ananda Lowe who writes a blog, thedoulaguide, about childbirth issues of all sorts. (Disclosure: she is also my co-author on a book we wrote on how to have a fulfilling and fully-informed birth experience.)

Ananda explains that a new “natural cesarean technique” is being developed here in Boston at Brigham and Women’s Hospital:

While talking with my friend Dr. William Camann, director of obstetric anesthesiology at Brigham and Women’s hospital in Boston, I was surprised and excited to learn that he recently helped the hospital adopt components of what is being called “the natural cesarean” technique. Bill is co-author of the book “Easy Labor: Every Woman’s Guide to Choosing Less Pain and More Joy During Childbirth,” and the Brigham is Boston’s largest maternity hospital, so its adoption of these methods is good news. In the past, some mothers reported feeling “a disconnection from their cesarean baby because they did not actually see or feel the baby born,” according to the International Cesarean Awareness Network (ICAN). The natural cesarean technique offers parents the option of viewing the emergence of the baby if they wish. (For years, ICAN has been a pioneer in proposing guidelines for family-centered cesareans, as well as advocating for other reforms related to the use of cesarean sections—I encourage everyone to support their work!)

I spoke with Camann today and he said the preferred term for the new technique is “family-centered Cesarean,” or “gentle Cesarean.” The concept has been evolving for several years, he said, with some elements of it — like early skin-to-skin contact between mom and baby in the operating room — becoming more standard. The newest element — a clear surgical drape that allows the mom to actually see the birth — just started a few months ago. “To my knowledge, the Brigham is the only hospital doing that,” Camann says. “It was my idea; the patients love it.”

A "natural" or "family-centered" Cesarean section. (Photo courtesy Dr. Bill Camann)

A “natural” or “family-centered” Cesarean section. (Photo courtesy Dr. Bill Camann)

But a bird’s eye view of a surgical birth isn’t for everyone, he added, and some new moms don’t want to see anything. “You pick up cues from the patients and other providers,” Camann says. “It’s very much a judgement call.”

Here, Camann offers more details on the technique:

A growing movement is attempting to make the cesarean delivery a more natural, or family-centered, event.

Modifications of the standard technique include:
· Early skin-to-skin contact in the operating room (with either mom or dad)
· A slow delivery (with intent to mimic the “vaginal squeeze”) Continue reading

11 Ways To Lower The C-Section Rate (Your Suggestions Included)

Everyone’s been through it. But for some reason, the topic of childbirth seems to get people awfully riled up.

Readers responded passionately to a story we posted earlier this week about the rate of cesarean deliveries in the U.S. creeping up to 50 percent. The comments section included some intense back-and-forth on how to fix things.

So here are 11 suggestions for lowering the c-section rate. The first six come from John Queenan, an emeritus professor at Georgetown University’s department of obstetrics and gynecology and author of a recent editorial on the topic in the medical journal Obstetrics and Gynecology. The last batch are from readers.

1. Get a commitment from hospital obstetric departments to work on lowering the C-section rate and also cut down on the number of drug-based labor inductions. (See this related post on pregnant women inducing their own labor.) Continue reading

Will The C-Section Rate Soon Hit 50 Percent?

A doctor wonders how to stop the relentless rise in C-sections

Pretty much everyone agrees that the number of cesarean deliveries in the U.S. is too high: the rate has soared from 6% in the 1960s to 32% today.

In a recent editorial in the medical journal Obstetrics and Gynecology, Deputy Editor Dr. John Queenan suggests that we have yet to reach the peak. “The rate is likely to exceed 50% very soon in the U.S.,” he writes. “How can we curtail this runaway increase in cesarean deliveries?”

What’s really troubling, says Queenan, Professor and Chair emeritus at Georgetown University’s Department of Obstetrics and Gynecology, is that almost one-third of C-sections are for women who are having their first child, and that sets up a vicious cycle of future surgeries since vaginal births after cesareans (VBACs) are decreasing — some hospitals won’t even do them. Continue reading