Parents have been negoitiating caesarean births that better meet their needs for many decades, requesting support to make the focus the birth of their baby and not the surgical event. (Lowdon & Chippington Derrick, 2004)
Family-centred Caesarean birth (FCCS) generally refers to one or all of the following; a slow physiological birth of the baby, optimal cord clamping and delivery into skin-to-skin. A version of these adaptations to the traditional Caesarean procedure was first described in BJOG in 2008 (Smith et al, 2008), and has not so far been found to be associated with any increased rate of complications for the birthing woman or baby (Bronggeest et al, 2019, Korteweg et al , 2017).
NICE recommend that women’s preferences for birth such as de medicalisation of the delivery experience should be facilitated where possible (NICE, 2015). This can foster a sense of involvement and empowerment in the birth process, which can be significant in alleviating feelings of detachment and disconnectedness that some experience, particularly following previous traumatic birth experiences. These techniques can allow for an immediate bond between parent and baby, leading to greater success in breastfeeding initiation.
Occasionally, the mother or birthing person may prefer to assist with the birth of the baby – termed “maternal-assisted Caesarean” (MAC). This can be safely facilitated where the situation and team experience allow. By allowing a slow delivery of the neonate’s body without the use of fundal pressure, a more physiological birth can hopefully be achieved with less discomfort for the patient. The principle for the surgeon is hands off, giving time for autoresuscitation whilst the uterus contracts to expel amniotic fluid out from the lungs. Theoretically this practice mimics vaginal birth and aims to achieve a more physiological adaptation to extrauterine life, as well as enhancing the birth experience for the woman/birthing person and their partner (Smith et al, 2008).
The following video from Maidstone and Tunbridge Wells NHS Trust focuses on delayed cord clamping and skin to skin care at caesarean birth.
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