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A Gentle Approach to Cesarean Birth

When Edwards resident Tiffany Oetting went into labor at Vail Valley Medical Center having a Cesarean birth or C-section was “not part of the birth plan.” The necessity of the surgery became apparent when her labor stalled. She shared “I was scared and disappointed that I could not give birth the way I wanted to.”

“When I knew I would have to be in the operating room it really scared me” Oetting said. “But the nurses doctors and anesthesiologist assured me that they would do their best to give me as much of the same experience as I would have had if I would have given birth vaginally.”

One-third of babies born in the United States are delivered via C-section each year according to the Centers for Disease Control and Prevention. The “gentle Cesarean” method was initially introduced in the United Kingdom in 2005 in an effort to make the experience more inclusive and less intimidating for the parents.

The trend has been emerging more readily in United States birthing centers in the last decade and in the past two years Vail Valley Medical Center's Women and Children's Center has been implementing changes to make the surgical process more comfortable for mom baby and family.

“VVMC strives to create a family-centered birthing environment” explained President and CEO Doris Kirchner. “The gentle Cesarean is another meaningful step in providing patient-centered healthcare for the families in our community.”

“The Family-Centered C-Section is an initiative to provide a more satisfying birth experience for our patients” said Colleen Gosiewski a registered nurse in the Women and Children's Center. “Even though the family may be in an operating room and it may not be part of their original plan we want them to have a comfortable memorable birth experience.”

The gentle Cesarean represents a cultural shift from the way babies have traditionally been delivered via C-section. VVMC's Family-Centered C-Section initiative is helping set a new standard of care and focuses on three main points:

1. Minimal to no-family separation.
The mother's support person is invited to join her in the operating room (O.R.) and can sit with her during the spinal placement (spinal anesthesia) and stay in the room throughout the procedure. Support persons used to have to wait until the spinal placement was complete to come into the O.R.

“We have found that keeping the family together is really great so that everyone sees the entire procedure everyone knows what's going on and there's no question about what's happening with a loved one in the O.R.” Gosiewski said.

When the surgery is over the mother her support person and the baby all leave the operating room together and are taken directly to their birthing suite. Traditionally the mother would be taken to a recovery room first separating her from her support person and new baby.

“We find that if we take them from the O.R. back to their birthing suite then they are in their own environment and they are all together” she said. “They can have grandparents and other family members in the room with them as well so it's a more immediate family experience.”

2. Skin-to-skin and breastfeeding initiation in the O.R.
After the baby is born as long as he/she and the mom are medically stable the baby goes directly to the mom's chest and is with her while the operation is complete. This is a step that is readily practiced in vaginal deliveries but in traditional C-sections babies are often wrapped up and whisked away from their parents.

“If baby can be skin-to-skin with mom the contact with her body can usually normalize the baby's temperature. In addition this immediate contact is shown to help mom and baby bond and also to help the initiation of breastfeeding sooner than later” Gosiewski said.

3. Creating a calm personalized atmosphere.
To make surgery in the O.R. more inviting VVMC gives moms the option to choose their own music to be played in the room. Oetting recalls listening to her “birthing playlist” from her iPod. They also dimmed the lights for her.

Not all moms want to have special music or mood lighting but some do explained Gosiewski.

“It's kind of nice” she said “because when you are entering an O.R. it's typically a little frightening when you first go in and these little touches can help the area feel more comfortable.”

Patient Priority
Oetting said she didn't actually know that she was having a “Family-Centered C-Section” during or even after it happened. It was later when she read about the growing trend that she realized how “lucky” she had been. She said she has met moms in the area who were not aware they could have such a birth at VVMC and hopes to share her experience so women know how fortunate the Valley is to have this option.

“I never felt like I was in an operating room and the fact that I got to hold my baby girl almost immediately while still laying on the O.R. table made it that much better” Oetting said. “My daughter was even able to start nursing right away just seconds from being born because I was able to hold her on my chest.”

The gentle Cesarean is meant to enhance the birthing experience of families requiring C-section and just like the options offered to women giving birth vaginally these are only implemented if they will not interfere with the birthing procedure and health of the patients.

As the gentle Cesarean approach becomes the norm in hospitals across the United States VVMC's Women & Children's Center will continue to focus on partnering with their patients to provide the best in family-centered care.

Kim Fuller is a freelance writer based in Vail.

About Vail Valley Medical Center
From modest beginnings in 1965 Vail Valley Medical Center has grown into one of the world's most advanced mountain hospitals providing Olympic-quality sports medicine leading evidence-based research modern cancer care and extensive cardiology services – all top-quality services with exceptional outcomes. An independent nonprofit medical center VVMC keeps hundreds of jobs and resources local better serving our community and visitors. Providing superior health services with compassion and exceptional outcomes VVMC offers expanding services low infection rates free community services and top-rated patient satisfaction scores. For more information please visit