Monday, January 21, 2013

The Mother-Friendly Cesarean - A Ceci Jane video debut

I have mixed feelings about writing this post.  I don't want to glorify the cesarean or make it look desirable.  It's become so common to elect for a cesarean section instead of experiencing childbirth.  I honestly believe fear is at the root of this epidemic.  I've been there with my first baby - I get it. But that is not the purpose of this post.

This post is about those women who want and have planned for an unmedicated birth.  They dream of the water birth in the quiet, dimly-lit room, where their baby is baby is placed immediately on their chest.  They want to experience the oxytocin and bonding that is held so precious in natural birth circles.  They want to be empowered through their natural birth.

Every now and then a cesarean birth becomes the only option.  I'm not talking about the mom who didn't do any classes and has placed all her trust in her OB who tells her it's dangerous to go past 40 weeks and her baby is too big anyway.  I'm talking about the mom who truly has no other options.  My graphic designer for Birth Boot Camp, who had a bicornuate, or heart-shaped, uterus.  She tried everything possible to get the baby to turn before finding out why her baby couldn't get head-down, or even butt-down.  It broke her heart to have a cesarean.

Sometimes a cesarean is actually even a better option than a vaginal birth.  I bet that surprises many of my readers to hear me say that.  I've been talking with a mom, who, at 18, gave her baby up for adoption.  She had an episiotomy which led to a 4th degree tear, or into the rectum.  For many years, she has lived with a poorly stitched perineum and has had many issues. She had a reconstructive surgery, but is still dealing with problems and pain. Now, at 9 months pregnant, she's been advised to have a cesarean.  She's getting a second opinion, of course, but she is devastated.  She's been preparing for and looking forward to a homebirth.  The doctor explained that the skin and muscles between the vagina and rectum are paper thin and she has a significantly shorter perineum.  He is convinced that the baby will tear things open as he/she passes through.  He said she is certain to be looking at another surgery with probable lifetime incontinence and even leaking fecal matter through the vagina.  Of course, there is no guarantee that is how things are going to go down, but at some point, you are left deciding which surgery do you want to recover from?  Which possible life-long effects from which surgery are you more "willing" to deal with? I am grateful I was never forced to make a decision like that.  I honestly am not sure what I would choose and it's not my place to tell her what I think she should do.  She is informed and she will make the right decision for her family.

The moms that have been in this position are left mourning the loss of what they didn't have - their natural birth.  All the "at least you have a healthy baby" comments often make them feel guilty for being sad about their birth. It's OK to be sad or disappointed.  If the sadness is interfering with bonding or parenting, seek help.  Talking about it with people who understand will help.

If you are in this situation of having an unwanted cesarean, it doesn't have to look so different from the immediate postpartum vaginal birth.  Many women want their baby immediately and they don't want to delay breastfeeding.  My good friend, Ceci Jane, recently filmed a birth video for a family desiring a Mother-Friendly cesarean.  She called me immediately after this birth, so excited!  She said it was amazing, that it "felt" very much like a vaginal birth. I've worked with Ceci on a number of projects, including Birth Boot Camp (read about her version of recording/editing the documentary-style classes), and I knew she had been asked to film this video a few months ago.  I am honored she allowed this debut to take place here on Banned From Baby Showers. The mother and father were treated with such respect and their wishes were honored.  Rather than spoiling this special video, I'll let it speak for itself.  Grab your tissues.

Uriah Nehemiah from Ceci Jane on Vimeo.

So, you've seen the video, but the question inevitably comes up - What makes this a Mother-Friendly Cesarean?  You are always hearing me talk about the Mother-Friendly Childbirth Initiative written by CIMS.  Many of those steps can be applied to cesarean birth as well.  A Mother-Friendly cesarean is a gentle cesarean, for one.  The baby - and the mother - is not handled so aggressively.  The cord is not immediately clamped, but rather the baby receives all of its cord blood.  Mother has the baby handed to her in a matter of seconds.  In this birth video, baby stayed on his mama's chest for a solid 2 hours.  Baby breastfeeds soon after birth, like a vaginally born baby would.  Newborn procedures, including weighing the baby, were delayed until parents were ready.  Like anything else, if the consumer demands things be done a certain way, eventually, we will see change.  If you find yourself in this situation, where a cesarean is the last - or best - option for you and your baby, request a Mother-Friendly cesarean.

Ultimately, no matter how your baby enters the world, you are becoming his or her parents.  We wish a gentle birth for all babies, but so much of that is about the first minutes and hours of his/her life.  We talk so often about natural birth being empowering, but empowerment also comes from knowledge and making informed decisions and having those wishes and decisions respected. Some of the best mothers I know had cesarean births.  You can still breastfeed, co-sleep, and wear your baby. Ultimately, it doesn't make you a better mother just because your baby came out of your vagina.


Kelly said...

Although my CBAC wasn't as mom focused as we planned and I still grieve over the loss of my last two births, I don't think cesareans have to be all awful either.

Shazia Lackey said...

I think if all cesareans were performed so that mom was more a part of the process and immediate skin to skin and breastfeeding occurred, they would be less traumatizing to moms who had prepared and truly wanted a natural birth, but needed a section.


Melissa said...

What a beautiful mamma and family! What a peaceful birth.

Naomi Joy said...

Thank you for this! I have a fabulous doctor and my 1 birth out of 4 ended up cesarean because he was breech and wouldn't turn. I didn't even say anything but I was given the baby immediately and as soon as I was stitched up, he was returned to me for unlimited breastfeeding. I actually got to nurse him longer than I did any of my other ones after the vaginal births! And after 4 kids, I guess I've learned that although those first moments seem so crucial to the child's whole life, they really aren't - and neither are the first hours or the first days. If something goes wrong and you don't have things exactly how you like, you'll make up for the time you lost later and the baby and the relationship are the same as they would've been otherwise.

Emily Robb said...

This post is incredibly timely for us! We've been planning a second natural delivery and have just had some complications that may make it necessary in the end for a c-section. Right now, I am grieving for the possible loss of the birth we planned on and trying to plan for the best outcome we can possibly have. I appreciate your acknowledgement of this process!

Melody DeLury said...

Like your friend, my first baby was breech because of my odd shaped uterus. I had a septate uterus which was corrected by metroplasty in 05 and left me with an arcuate uterus. My son (5/09) was breech from about 23 weeks until my c/s. He wasn't turning, he never flipped back and forth. My daughter (8/12) was in proper position but we elected a repeat c/s because I've not had surgeries at the top and bottom of my uterus and the risks were too high of rupture (not to mention I have a clotting disorder to boot) for my taste. I really love your post, I wish I would have read it prior to my daughter's delivery. We still had a nice birth and I healed pretty well. It's always a little painful to read natural birth advocates posts, as if any other way makes you less of a mother.

Mellanie said...

Incredibly beautiful! All of Ceci's birth video's make me cry, so I had to wait to watch this one until the kids were occupied. :-) And I totally agree with you - yes, c/s's have become entirely too common, but they are sometimes necessary and those moms and babies deserve beautiful, gentle births too.

Juba said...

Please tell your friend my history: I had a gentle cesarean because I had a heart shaped uterus, and the baby was with her feet on the way out and never turned.

The second pregnancy was full of issues, the baby was transverse and there was problems with the placenta. We were going to do another cesarean at 38,5 weeks, but in the start of 38 week the baby just turned and the placenta starts to ascend.

The baby turned 5 times after that! Sometimes transverse, oblique, breech, cephalic... And gave birth at 42 week, with induction, in a lovely VBAC.

I'm sorry about my English, I live in Brazil and did not learned so much.

Ashli Rae said...

This is such a beautiful video. Thank you for sharing! I wish I would have had the option of a gentle cesarean when I had our son. I'm about to have Baby #2 and we do have that option at our new hospital! We've moved to a new state. It thrills me to have this option. The loss of immediate bonding was the worst part of my first c/s which would be addressed with a g/s. Thank you for sharing this wonderful video!

Jacob Johnson said...

I would really like to use this video in my childbirth education class. Could I get permission to use it? I tried emailing, but I am having technical difficulties :/ You can email me at

I love your blog!