The natural caesarean: a woman‐centred technique

Abstract

Although much effort has gone into promoting early skin-to-skin contact and parental involvement at vaginal birth, caesarean birth remains entrenched in surgical and resuscitative rituals, which delay parental contact, impair maternal satisfaction and reduce breastfeeding. We describe a 'natural' approach that mimics the situation at vaginal birth by allowing (i) the parents to watch the birth of their child as active participants (ii) slow delivery with physiological autoresuscitation and (iii) the baby to be transferred directly onto the mother's chest for early skin-to-skin. Studies are required into methods of reforming caesarean section, the most common operation worldwide.

Bridging the Gap between Evidence and Practice: A Systematic Review—When Is the Best Time to Clamp the Infant’s Umbilical Cord in Term Low-Risk Women?

“…While delayed cord clamping is possible with cesarean sections (Smith, Plaat, & Fisk [18]), cord milking is more convenient and seems to produce similar results. The infants whose cord was milked had significantly higher hematocrit values than those whose cord was clamped immediately.…”

The neuroscience of birth – and the case for Zero Separation

“…Maternal and fetal outcomes are profoundly improved when doula care is provided (American College of Obstetricians and Gynecologists 2014) along with 'natural birth' (Mercer et al 2007;Smith, Plaat & Fisk 2008), as well as when the ecologically-valid environment that produces the 'GxE' described earlier is ensured. Although the technology and skills available for newborn and preterm care are wonderful, they do not require separation; they should instead be applied to the right place, the mother's chest (Phillips 2013;White 2004).…”

La césarienne naturelle

“…Le décubitus latéral est bien sûr retiré dès la naissance. Smith et al rapportent que dans certains cas, le scope capte la fréquence cardiaque du nouveau-né faisant faussement suspecter une tachycardie maternelle [7].…”

“…Il est possible de transformer l'expérience que représente la césarienne et de la rendre plus conforme à l'image d'un accouchement naturel par des mesures simples, mais qui sont soustendues par un véritable changement de culture des personnels de maternité. Le texte ci-dessous reprend la plupart des concepts exprimés par Smith et al dès 2008 [7]. Cependant force est de constater que depuis cette publication, le nombre d'articles consacrés à cette « philosophie d'accouchement » reste très limité, justifiant d'une diffusion plus large de ce concept et de sa mise en oeuvre pratique.…”