”You’re having a c-section with NO ANAESTHETIC?!” The response of my dear (clearly demented) friend Jess to news that I am to receive a ‘natural cesarean’ at one of London’s leading NHS hospitals is testimony to why consultant midwife Belinda Green, who is pioneering the procedure, has decided to take its other name – the ‘skin-to-skin cesarean’ – for the purpose of a new study which launches next year.
After all, the description is misleading. As Green explains, there is nothing natural about a c-section of any kind. But for some women cesarean it is the safest option; and the purpose of the trial for which I have been asked to be guinea pig – a trial which will launch at University College London Hospital (UCLH) next year with the film of my baby’s birth shown to women participating in the study to demonstrate what is involved – is to replicate as closely as possible the experience of vaginal birth for women for whom natural delivery is not a viable option.
Not currently offered on the NHS in Britain, Belinda Green and her team hope to prove through their forthcoming Randomised Controlled Trial (RCT) the positive outcomes for both mother and baby this kind of ‘slowed-down section’ can offer. Outcomes including improved bonding between mother and child, more easily established breastfeeding, and calmer newborns.
When I was first approached by Green, who previously ran the birthing centre at UCLH and now works in antenatal with a clinical and research interest in Vaginal Birth After Cesarean (VBAC), if I’d like to be the model for the trial, I was immediately intrigued.
Having been born at this very hospital myself, some 32 years ago, and having had my first two children here by c-section – the first the result of a failed induction, the second as a result of not going into labour at 42-plus weeks, and showing no signs of – I had often wondered what it would be like to actually hold your baby before it is whisked off to be weighed. To experience more of my child’s birth than a quick glimpse over the paper partition that masks women from the somewhat severe clinical procedure being performed inches from their face during a standard section.
While I was eternally grateful for two healthy children who may well never have made it into this world without the grace of medical advances, I still wondered…
Dr Ruwan Wimalasundera, a Consultant Obstetrician and Fetal Medicine Specialist at UCLH, has been performing so-called natural cesareans to his private patients for the past 10 years. More common in the US, the procedure is much slower than a standard cesarean, he explains when we meet prior to my elective surgery.
Once the incision is made to the abdomen as per the standard method, he says, and the baby’s head emerges, rather than whisking the baby out as quickly as possible and taking it straight off to be cleaned and weighed under the lights – at which point both of my previous babies had screamed uncontrollably while I looked on helplessly, hoping for a glimpse and longing to soothe them myself – the newborn, I’m told, will be allowed to push and squeeze its way out into the world, as long as there are no obvious complications.
This will enable the baby to clear its own lungs, as it would during natural birth; and once it is free the surgeon will lift the baby out – with cord still attached, if it’s long enough – and pass it to the midwife who will hand it straight over to me, where it will rest for several minutes while I’m being stitched back together.
On the day, I arrive at surgery armed with a newborn hat (the greatest concern about immediate skin-to-skin is that baby will get cold in a theatre environment). Belinda Green is armed with a roll of tin foil, to lay over the towel that will rather glamorously enshrine me and the baby.
The atmosphere in theatre is one of eager anticipation, and despite the familiar array of catheters, scalpels et al (and needle to administer the spinal epidural) I find myself grinning with excitement. All goes according to plan, and watching my son’s body slowly emerge, once the screen between us has been lowered, is a moment I can still hardly believe was real. While my other children had screamed for minutes on end after first emerging, the moment my youngest son’s head is placed on my chest, still covered in mucus, he immediately calms.
For the first time I’m able to marvel at the perfection of my bloodied, puffy-eyed newborn before anyone else. A sense of quiet elation enfolds us both as the buzz of the surgery melts away. All that remains is me, him, his father, a sense of total contentment, and the nagging joy of being one step closer to the sandwich in my hospital bag, after 16 hours nil by mouth…
A week or so later it’s impossible to say for certain quite what the impact of this delivery was, but I can honestly say that of all my three children (all equally delightful, of course) this baby has been by a long shot the most calm and content, latching onto the breast with ease and hardly ever grizzling or crying. And despite juggling three kids, and all the rest of it, I’ve never felt calmer as a new mother.
Of course this might have something to do with the reassurance of having done it all twice before, but I also believe that sense of ease is in no small way buoyed by the security provided by the memory of watching my child emerge, triumphantly, into the theatre like a small, warm and very hairy statue of liberty. Not to mention the sense of fulfilment at being the first one to welcome him, soothe and protect him from the throbbing noise and bright lights of the outside world.
