Promotion of Family-Centered Birth With Gentle Cesarean Delivery

Abstract

Purpose: In this commentary we describe our experience developing a "gentle cesarean" program at a community hospital housing a family medicine residency program. The gentle cesarean technique has been popularized in recent obstetrics literature as a viable option to enhance the experience and outcomes of women and families undergoing cesarean delivery.Methods: Skin-to-skin placement of the infant in the operating room with no separation of mother and infant, reduction of extraneous noise, and initiation of breastfeeding in the operating room distinguish this technique from traditional cesarean delivery. Collaboration among family physicians, obstetricians, midwives, pediatricians, neonatologists, anesthesiologists, nurses, and operating room personnel facilitated the provision of gentle cesarean delivery to families requiring an operative birth.Results

The gentle family-centered cesarean

“…6,7) No increases in maternal or neonatal complications were found, including surgical site infections, maternal blood loss, requirement for blood transfusions, or any neonatal parameters. One study 7) showed a shorter time to hospital discharge (4.0 vs. 4.4 days, P < 0.001) with the gentle cesarean vs. a traditional cesarean, and fewer instances of hospitalization more than 4 days (17% vs. 30%, P < 0.001).…”

“…2,3) The "gentle", or "family centered" cesarean delivery is an approach to operative delivery that reduces the emphasis on surgical rituals and processes and increases the clinical focus on the mother, the baby and the family. [4][5][6][7] The change in perspective celebrates the momentous birth event and encourages early motherinfant bonding. This concept has also become known as "kangaroo care", owing to the methods that marsupial animals use in the early care of their young.…”

Mother’s Experiences and Perceptions of a Continuous Caring Model with Fathers after Caesarean Section: A Qualitative Study

“…7 In America, family-centered "gentle caesarean" programmes enable mothers to have skin-to-skin contact during surgery. 13 Hospitals in Europe have developed nursing intervention protocols to minimise mother-infant separation after caesarean births. 14 These programmes have been shown to positively affect maternal-infant interaction and breast feeding initiation after caesarean delivery.…”

Exploring Parental Expectations and Experiences Around “Gentle” and “Standard” Caesarean Section

“…Subsequently, the baby is placed immediately with the mother to provide early skin-to-skin contact [8]. Despite a lack of studies investigating the safety and true benefit of such an approach, more and more hospitals are implementing (a variation on) this technique [9,10].…”