Gentle C-section on the NHS - is it possible?

[JoyApple]

Hi,

Looks like I'm going to have to go for a planned C-section due to a large posterior fibroid near the entrance of my cervix. I was wondering if it's possible to have a gentle c-section on the NHS? And if anyone has had any experience of it please? Especially the slow delivery. Thanks

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From what I've read a gentle c-section includes:

• Clear drapes: A transparent drape or lowered drape allows you to witness the birth of your child.

• Slow delivery: The baby is delivered more gradually to mimic the process of a vaginal birth.

• Immediate skin-to-skin contact: You can hold your baby against your chest right after birth.

• Delayed cord clamping: The umbilical cord is usually not clamped and cut until after a few minutes.

• Reduced anesthesia: Lower levels of anesthesia may be used to allow for greater alertness.

I had delayed cord clamping and immediate skin to skin with my most recent section x

Hi

I had 3 c sections on the nhs. They have always been accommodating (where possible)

With my first baby it was impossible to have skin to skin as he was taken to the side for a quick check as he wasn't crying.

The other two it was possible to have them passed straight on me and have skin to skin.
They asked if we wanted music & to lower the curtains too. To which we said yes.

Not sure about the level of anesthesia .. I would go with what they recommend. They know best 😃 trust me you will want to be completely numb on your lower half 🙃

Good luck hope it all goes well x

Most of that is standard anyway with an elective. Delayed cord-clamping, immediate skin to skin, not sure what you mean about reduced anaesthesia and alertness, the spinal has never affected my alertness mentally.

Electives are very calm, often music playing, they will often lower the curtain if that's what you want. Just note it in your birth plan🥲.

I’m not sure about the transparent drapes but even I got immediate skin to skin after my EMCS, they just had to make sure he was ok first, which took a few mins.

I’m going in for a planned one this time and i’ve been told they will be able to do delayed cord clamping.

TBH never heard of the ‘slow delivery’ bit. I can’t imagine how it would mimic a vaginal birth tbh.

With anaesthetic, you are not knocked out. I had a spinal. You may want to take into consideration that with any type, you have risk of your blood pressure dropping or you being sick, so you may be less aware of what’s going on sometimes. But as PP said, you WANT to be numb. You are having major surgery.

I asked about this but didn’t have a c section in the end. I was told

• Clear drapes: A transparent drape or lowered drape allows you to witness the birth of your child. - they were fine with this.

• Slow delivery: The baby is delivered more gradually to mimic the process of a vaginal birth. - no, because of the risk of infection in mother and distress in baby.

• Immediate skin-to-skin contact: You can hold your baby against your chest right after birth. Yes, as long as the baby was breathing immediately. It’s not unusual for babies to need suction first and then they can have sink to sink.

• Delayed cord clamping: The umbilical cord is usually not clamped and cut until after a few minutes. I was told unless there was a problem this is standard.

• Reduced anesthesia: Lower levels of anesthesia may be used to allow for greater alertness. Only cat 4 section require a GA otherwise they use spinal block. Cat 4 sections happen when there is an immediate threat to mother or baby’s life. The hospitals in our area in this situation aim for delivering of baby to happen from 10 mins of decision being made, this includes getting all the right people to theatre and scrubbed up so GA is the only way.

Hi there I work as NHS midwife. You can ask to lower the drapes, it's absolutely no issue. Delayed cord clamping is standard these days (unless you start bleeding heavily- highly unlikely - if this happens the doctor will need to prioritise stemming the bleeding). In my hospital baby comes to mum after a few minutes check for skin to skin- you can ask for it in advance and let's hope your hospital is either doing it already or can accommodate. Lifting the baby gently out of the womb is a marketing gimmick for private providers. It has no benefits for the baby, if anything the baby could get cold as operating theaters are kept cold. Elective CS are done under spinal with no sedation- so you will be alert but no pain. I hope it helps

Thanks all!

The slow delivery method mentioned can be seen here:

I've had surgery before and always felt very cold in theatre. So I can understand the concern about baby feeling cold ...

Re. the anaesthetic:
a cat 4 section is elective and would typically be done with spinal anaesthetic. There are some times though when that isn’t possible and GA is used.

a cat 1 section where there is an emergency with threat to materal or fetal life and is more likely to be done with GA.

either way, reducing the anaesthetic is not appropriate because it would be inadequate for the procedure (either not numb enough or not asleep enough). HTH.

Sorry I meant 1.

Can I ask if you know if prolapse gets worse with a vaginal birth and with a second pregnancy could it possibly go away?! I think I want to request a c section