A gentle C-section (also called a family-centered cesarean) is a growing movement to bring more connection and warmth to surgical births. Just like with a vaginal birth, a mother can have preferences during a C-section, and as long as it is medically safe, the care team should make every effort to incorporate them.
In this article, you’ll read about what gentle C-sections tend to include, why families might consider them, and how to advocate for one.
What is a Gentle C-Section?
A gentle or family-centered cesarean may include elements that mirror the emotional and physiological benefits often associated with a vaginal birth—like skin-to-skin contact, delayed cord clamping, and a more calming environment (1). While the surgical procedure remains the same, the atmosphere and protocols shift to emphasize connection, bonding, and comfort.
When is a Gentle C-Section an Option?
In many cases, a gentle C-section is an option for both planned and unplanned cesareans, as long as the health of the baby and mother allow for it.
Families who know in advance that they’ll be delivering via C-section can often prepare ahead of time and work closely with their provider to build a birth plan that includes gentle modifications, but even in the scenario of unplanned c-sections there may still be opportunities to incorporate practices like delayed cord clamping or skin-to-skin in the recovery room. Some hospitals are now implementing these practices as standard procedures.
It is important to note that in certain emergency scenarios, where every second counts, some gentle elements may need to be set aside to protect the well-being of the baby or parent.
Gentle Cesarean Options
One of the first things to consider when thinking about your desires for your birth experience is the environment. In a typical labor and delivery room, mothers often have the ability to personalize the space and shape the mood. Examples of this might include dimming the lights, choosing who is present, and playing meaningful music. An operating room can feel bright, sterile, and busy, with multiple staff members talking, machines beeping, and little room for personalization… But even in this clinical space, it’s possible to make small changes that make you feel more comfortable.
Families can ask staff to keep voices low and limit nonessential conversations, and many hospitals allow parents to play music of their choosing in the OR. These small details can make a big difference in allowing for your birth to feel less like a “procedure.”
Below are additional elements that parents may choose to request during a gentle cesarean:
Clear or Lowered Drapes
Some families request a clear surgical drape or ask to have the drape briefly lowered during the moment of birth (2). This allows the birthing parent to see their baby being born, a moment typically hidden during a conventional C-section.
For some parents, witnessing their child’s entrance into the world is a deeply emotional and meaningful experience. For others, the thought of seeing the surgical field may feel overwhelming or uncomfortable. Neither choice is right or wrong
Immediate Skin-to-Skin Contact
When medically safe, the baby can be placed directly on the mother’s chest while still in the operating room. Birth teams can plan for this by placing the blood pressure cuff and IV on one arm, leaving the other arm free and ready for baby. Early skin-to-skin time helps regulate the baby’s temperature, while also supporting breastfeeding and bonding (3). If the mother is unable to hold the baby immediately, skin-to-skin can often happen with a partner instead.
To learn more about skin-to-skin care, read this article: The Benefits of Newborn Skin-to-Skin Contact
Delayed Cord Clamping
Delayed cord clamping is the practice of waiting, typically 1-5 minutes, before clamping and cutting the umbilical cord after birth. This allows for continued blood flow from the placenta to the baby, providing important benefits like increased iron stores, improved circulation (4), and a smoother transition to life outside the womb.
It’s a common misconception that delayed cord clamping can only be done after a vaginal birth. In reality, it is often possible during uncomplicated cesarean deliveries as well (5). Many obstetricians now support this practice in the operating room when both the mother and baby are stable. If it’s important to you, be sure to include it in your birth preferences and discuss it with your provider ahead of time.
If delayed cord clamping is not possible during your c-section, an alternative would be cord milking (6). Cord milking is the practice of gently squeezing the umbilical cord several times toward the baby before clamping it, helping to push more blood, iron, and stem cells into the baby when delayed clamping isn’t possible. This technique is particularly valuable in cesarean deliveries where the natural contractions of the uterus, which facilitate blood transfer to the baby, are absent or reduced.
To learn more about delayed cord clamping, read this article: Delayed Umbilical Cord Clamping: The Benefits & Risks
Minimal Separation & Slow Transitions
Many gentle C-section protocols emphasize keeping the baby in the same room with the parents as much as possible and creating a calm and gentle environment for baby’s first moments earthside. This means that rather than lifting the baby quickly and stimulating them under bright lights, birthing teams can take action to facilitate a slow, gentle birth, allowing the baby to emerge gradually and reducing stimulation in those first moments.
A gentle cesarean may also mean avoiding routine separation for weighing, measuring, or exams unless medically necessary. Many of these tasks can be done while the baby remains in arms, or bedside.
Microbiome Seeding
Some families choose to explore vaginal seeding, in which sterile gauze is placed in the birth canal prior to surgery and then used to wipe the baby’s skin, eyes, and mouth shortly after birth. The goal is to expose the baby to beneficial maternal microbes that they would likely have received during a vaginal delivery (7). While vaginal seeding is still under scientific investigation and not universally accepted, it may be something worth discussing with your provider. It’s important to note that this practice should not be performed if the birthing parent has group B strep, an active STI, or any condition that could pose a risk to the baby.
Placenta Encapsulation After C-Section
Placenta encapsulation is possible after a cesarean birth, just as it would be after a vaginal birth. If this is something you’re interested in, you’ll want to make arrangements before your delivery, including choosing a certified encapsulation specialist and ensuring your hospital can release the placenta to you, and you’ll need to be sure to include this request in your birth plan and inform your provider, so that the placenta is handled appropriately and not discarded.
To learn more about placenta encapsulation, read this article: Placenta Encapsulation: The Benefits & Risks
How to Prepare for a Gentle Cesarean
If you’re planning a C-section, or want to be prepared in case one becomes necessary, here are some things you’ll want to consider:
- Talk to your provider ahead of time about gentle cesarean options. Ask what’s available at your hospital and whether your provider is familiar with or supportive of family-centered practices. You may want to read this article, too: Assembling Your Birth Team: Who’s Who & How to Choose The Right Support For Your Pregnancy
- Include your preferences in your birth plan. Write your preferences down clearly and print several copies. Having all your preferences in one document makes it easier for the birth team to honor your wishes, especially during a busy or time-sensitive moment.
- Advocate respectfully and ensure your partner is informed and supportive. Partners often play a key role in reminding the team of your preferences and helping create a calm, connected atmosphere.
- Stay flexible. Birth is unpredictable, and not all preferences may be possible depending on the circumstances. It’s completely natural to feel overwhelmed when things don’t go as expected—but holding space for flexibility can help you stay grounded. Gentle, relaxing touches, like music or calming voices, can absolutely support a positive experience, but a hyperfocus on everything going exactly as planned can sometimes create more tension than peace.
Summary
A gentle C-section (sometimes called a family-centered cesarean) is a more personalized, emotionally supportive approach to surgical birth. It may include certain preferences like immediate skin-to-skin contact, delayed cord clamping, soothing music, clear drapes, and minimal separation from baby. Parents can advocate for their birth preferences by discussing options with their provider and being prepared with a clear written birth plan.
References:
- Camann, W. (2016). The gentle family-centered cesarean. Hypertension Research in Pregnancy, 4(2), 48–52. https://doi.org/10.14390/jsshp.hrp2016-004
- Christoph P, Aebi J, Sutter L, Schmitt KU, Surbek D, Oelhafen S. (2023). The extended gentle caesarean section protocol-expanding the scope and adding value for the family: a cross-sectional study. Arch Gynecol Obstet. 2023 May;307(5):1481-1488. doi: 10.1007/s00404-023-06913-0. Epub 2023 Jan 16. PMID: 36645503; PMCID: PMC10110671.
- Carmichael, A., & Matulionis, B. (2014). Implementing the Gentle C‐Section: A Birth Experience More Like a Vaginal Delivery. https://doi.org/10.1111/1552-6909.12379
- World Health Organization. (2014). Guideline: Delayed Umbilical Cord Clamping for Improved Maternal and Infant Health and Nutrition Outcomes. Nih.gov; World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK310514/
- Liina Lummevaara, Orden, M.-R., Anu Mykkänen, & Leea Keski-Nisula. (2024). Delayed umbilical cord clamping in elective and nonelective term Cesarean delivery. Journal of Gynecology Obstetrics and Human Reproduction, 53(2), 102717–102717. https://doi.org/10.1016/j.jogoh.2023.102717
- de Preud’homme d’Hailly de Nieuport SMI, Krijgh EJC, Pruijssers B, Visser J, van Beek RHT. (2024). Delayed cord clamping vs cord milking in elective cesarean delivery at term: a randomized controlled trial. Am J Obstet Gynecol MFM. 2024 Mar;6(3):101279. doi: 10.1016/j.ajogmf.2024.101279. Epub 2024 Jan 15. PMID: 38232817.
- The American College of Obstetricians and Gynecologists. (2017). Vaginal Seeding. Www.acog.org. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/11/vaginal-seeding
