C-section Birth: The Gentler Cesarean Method?

What is a C-section Birth?

Although nearly one in three children in Germany is born via cesarean section, very few women choose this mode of delivery from the outset. Many are even disappointed when it comes to that – whether planned for medical reasons or spontaneously during labor. The concern: The feelings of joy associated with a natural birth experience might be lost during a cesarean, which could complicate the bond between mother and child.

In 2008, a group of researchers addressed the question of how to make the delivery through the abdominal wall gentler and improve the birthing experience for the mother, child, and accompanying person. Based on the findings of this study, Prof. Dr. Wolfgang Henrich – the director of obstetrics at Berlin's Charité – decided in 2012 to briefly lower the drape during a cesarean section for the first time. This allowed the parents to have a clear view of their baby's birth, and the C-section birth was born! The idea behind it: A birthing experience that, despite being a cesarean, comes as close as possible to vaginal delivery – including feelings of joy and direct skin contact.

How Does a C-section Birth Work?

As with a standard cesarean section, a drape is initially placed during the C-section birth to prevent the parents from seeing the surgical opening of the abdominal wall. However, just before the baby is born – or as medical professionals say, developed – this drape is briefly removed. This way, the parents can see how the doctor lifts the baby's head out of the abdomen. The baby's body remains briefly in the mother's belly, allowing it to adjust gently to the outside world. The birth attendants can also check if the child is healthy or needs assistance.

In the next step, the mother is invited to push along – almost like in a natural delivery. Once the baby is fully lifted out, it is immediately placed on the mother's chest. If the father or the birthing companion wishes, the umbilical cord can now be cut with a sterile pair of scissors. After that, the drape is raised again, and the wound in the abdominal cavity is closed. Meanwhile, the parents can enjoy the first moments with their child.

Who is Suitable for This Method?

A C-section birth is suitable when a planned cesarean or a desired cesarean is performed. This means for scheduled deliveries that occur at a set time. In the case of an emergency cesarean requiring general anesthesia, a C-section birth cannot be performed. However, if only a epidural anesthesia (PDA) is present, the method can also be considered for a secondary cesarean – that is, an unplanned cesarean – provided that both mother and child are well and there is no acute medical emergency.

Where Can You Experience a C-section Birth?

Started as a trial in 2012 at the Berlin Charité, the C-section birth is now offered in many birthing clinics. However, not all hospitals practice this technique – and not all doctors do either. If you are planning a C-section birth, find out in advance which hospital near you offers this option.

Interview: What the Expert Says About C-section Birth

We asked the director of the clinic and pioneer of the method, Prof. Wolfgang Henrich, about his experiences.

PARENTS: Who is a C-section birth suitable for?

Prof. Dr. Henrich: It is important first that the parents want it and that the doctor is also willing. Then it is possible in many cases. But of course not in emergencies, when the woman is under general anesthesia or if complications are expected for the mother or child.

What if the parents can't stand the sight of blood?

They don’t have to see any during the C-section birth! Most people imagine a cesarean as a huge cut with the entire abdominal cavity exposed. But in reality, the cut is only ten to twelve centimeters long, and there is hardly any blood visible. Not to mention that the mother cannot see the wound at all due to the abdominal bulge. And when the baby's head appears, the parents will have no focus on anything else anyway. Therefore, I assure the parents during the preparation talk that they will not see anything they do not want to see. Additionally, they can also change their minds during the operation.

And how are the parents' reactions afterward?

Everyone who has done it so far is happy. I have not met a single mother or father who regretted it. On the contrary, many are very glad. One mother, who had already had two standard cesareans, said: "This child had a completely different entrance into the world than its siblings!"

It is said that during a C-section birth, parents can look their baby in the face right away. But most babies are born in the anterior occipital position. Shouldn't that mean they come out of the belly facing away from the mother during a cesarean?

The baby turns into the anterior occipital position only during labor. A cesarean is performed earlier, so the baby is usually still facing sideways. During the C-section birth, I slide my left hand under the baby's head, lift it, and turn it slightly towards the mother. This way, it has the very first eye contact with her, not with us.

Does pushing along really make a difference? Or is it more to give the mother the feeling that she can actively participate?

The mother can push a little, but it is also meant to give her the feeling that she can do something herself. And there’s nothing wrong with that.

If the method is so simple, why haven't C-section births been around for much longer?

I believe that obstetrics has long shielded itself behind exaggerated safety and hygiene regulations regarding cesareans. But a C-section birth is no less safe. And we have not had any infections so far.

Some cautioning voices say that the possibility of a C-section birth could lead more women to choose a desired cesarean to avoid the pains of labor. What do you say to that?

You can't always assume that women are seeking convenience! That does not do them justice, nor does it do justice to responsible birth attendants. We simply want to make necessary cesareans more humane with the C-section birth.

Can any delivery clinic perform a C-section birth?

Yes, any clinic that is willing to rethink the process of cesareans.