When it comes to writing a cesarean birth plan, people tend not to realize how many options they really have. It’s not uncommon for birthing people and their partners to have feelings of disappointment, failure, or even shame associated with the experience of having a c section. While a vaginal birth is seen as something magical and mystical that a person has done, a c section is often viewed as something that has been done to them. Both paths lead to birth, but one ostensibly comes with more positive feelings of choice, power, and strength. But we’re trending away from this dichotomy. No matter your delivery method, both vaginal birth AND abdominal birth come with choices and are worth making plans for.

There are no circumstances under which anyone has COMPLETE control over their birth experience. However, historically, expectant parents are more confident writing a birth plan for a planned vaginal birth than they are writing a cesarean section birth plan. Many folks assume that once they step foot into the operating room, they are no longer autonomous over their body or their experience. I’m here to tell you this is not true. A family-centered cesarean (also known as: “gentle cesarean” or “natural cesarean”) does exist. Let’s talk about how you can write a birth plan for your c section. 

How do I start writing a gentle cesarean birth plan?

Start by thinking through your birth plan for your cesarean. If the word “plan” feels too stringent for you, consider thinking of it as a list of your birth preferences. This denotes that *if* choices apply in any given situation, you’re communicating what you would prefer. Write out your birth plan. My best advice is to keep your written plan to the front side of one piece of paper. Make clear sections or bullet points. Keep it quick to read and easily digestible for any medical staff that are going to look at it. You don’t want them to have to read through several paragraphs to get to the point. Think about what matters MOST to you and make it short and concise. 

*Please keep in mind that in an emergency situation, all options may not be available to you. When we talk about options and preferences, it more often applies to a planned, non-emergent event. 

What can I request during my c-section?

What makes a cesarean “gentle” or “family-centered”? So glad you asked. Here are some options you may not know you have:

You can have music or sounds playing in the background 

Have you always dreamed of swaying mindfully to your favorite Tibetan chants? Is your goal to deliver your baby with Salt-N-Pepa encouraging you to PUSH IT? You don’t have to give that up. Make that playlist! Live your best birthing life! 

You can have a doula to support you 

Your partner will be able to be in the OR with you as long as you do not need general anesthesia (this happens only in emergency situations). But you can also have a doula with you. The benefits of having a doula present are:

• It ensures a continuity of care. If you’ve been working with a doula through your pregnancy and now your birth is scheduled to be a c-section, you can still have that familiar face and calming presence by your side through the procedure, in recovery, and in your postpartum space.
• The doula can provide support to your partner, while your partner supports you. 
• They can talk you through the process as it’s happening. 
• If your baby needs special care after birth, having a doula present could free up your partner to go with the baby while the doula stays with you.

You can have a birth photographer present 

This is still an experience that people typically have only one or a few times in life. You get to have it documented because it’s your experience, your truth, your transition into parenthood. Ultimately, the decision to allow a birth photographer into the operating room will be up to the doctor and anesthesiologist involved, however it is becoming more common to allow this (especially if your photographer is also serving as your doula). Just like a doula, a birth photographer will wear scrubs in the OR, respect the space of the medical staff and uphold hospital regulations, all while supporting you and beautifully chronicling your birth. 

You can choose delayed cord clamping 

This means that doctors don’t immediately clamp and cut the umbilical cord. Instead, they allow extra time for the blood in the cord and placenta to flow to the baby. There are so many benefits to delayed cord clamping, I encourage you to do some research on this. The ACOG website is a great place to start.

You can have maternal-infant bonding

Often times doctors will discourage the practice of immediate skin-to-skin contact for two reasons — but here’s what you should know:

1. It’s very cold in the OR. They like to quickly wrap the baby in several blankets and put it under warming lights so that the baby’s body temperature doesn’t drop. BUT your body temperature will regulate the baby’s body temperature if the baby is on your chest and there are warm blankets over both of you. Your heart rate also regulates the baby’s heart rate. Bonus! 
2. As the birthing person, you’ve had spinal anesthesia. This does not incapacitate your arms but it can make you shake involuntarily. You’re also laying completely flat. Laying down and having shaky arms doesn’t exactly create the safest circumstance for holding your baby. BUT with advance notice, it is in most hospitals’ clinical practice guidelines to have an extra nurse present in the room whose only assignment is to “spot” your baby while you hold him or her to your chest, shakes and all.

You can watch your baby emerge 

One of the best parts of labor is the opportunity to WATCH your baby being born. But with a cesarean, as a standard practice, there will be a paper “curtain” that hangs vertically at your chest area, blocking the surgical sight from your view. If you don’t think it will make you or your partner pass out, you can ask your medical team to use a clear curtain or to lower the curtain just before the baby is removed from your abdomen. 

Ok, I’ve written my Gentle Cesarean Birth Plan. Now what?

You can find a downloadable birth preferences template here. After filling it out, share your plan with your doula and/or birth photographer. Talk it through. Why did you make the choices that you made? Why do those things matter to you? Does anything seem unreasonable or unlikely in your specific situation? After that conversation, make any necessary revisions and print three to four copies. Bring one copy to your healthcare provider at your next appointment. Discuss your preferences with them and ask if there are any contraindications. Leave this copy with your provider to be added to your file. Give one copy to your doula, one to your photographer, and put one in your labor bag. 

If you don’t know your options, then you don’t have any. Know and understand the power and autonomy you hold over your own body and your own birth experience. Talk to your provider about it. Set yourself up for success, whatever that looks like for you. And when in doubt, PUSH IT!