| NEW YORK
NEW YORK (Reuters Health) - A cesarean childbirth procedure
developed in the UK takes a "woman-centered" approach and
incorporates many important aspects of natural childbirth,
according to a recent report.
"Vaginal birth has evolved markedly in the last 2 decades
so that much greater emphasis is now given to the experience of
the parents and to early bonding," Professor Nicholas M. Fisk
told Reuters Health.
By contrast, cesarean birth has changed little, said Fisk.
The emphasis is still on speed and resuscitation, even though
these are not necessary in straightforward cesarean deliveries
performed under epidural anesthesia rather than general
This led Fisk and his colleagues, from Queen Charlotte's
and Chelsea Hospital and Imperial College London, to modify the
obstetric, midwifery, and anesthetic practices of traditional
cesarean childbirth "to emulate as closely as practicable the
woman-centered aspects of 'natural' vaginal birth," they
explain in the medical journal BJOG.
The "natural" cesarean allows parents to actively
participate in and observe their child's birth, explained Fisk,
who currently directs the University of Queensland Centre for
Clinical Research in Brisbane, Australia.
At the start of the procedure, surgical drapes block the
incision area from the parents' view until delivery of the
infant's head. The field is then cleaned and the woman's
partner may view the birth at that point.
The obstetrician then slows delivery so uterine
contractions can help clear the infant's lungs, "just as
happens at vaginal delivery," Fisk noted. The baby's shoulders
are eased out "and the baby then frequently delivers his/her
own arms in an expansive gesture."
The mother can then see the half-delivered baby, and watch
the rest of the birth. The newly delivered infant is placed
directly on the mother's chest for bonding.
The set-up maintains the option of immediate traditional
c-section for babies showing unexpected distress, but babies
are usually crying and squirming before delivery is complete,
He also noted that there were "very few negative reactions"
among parents, and that hospital staff favored the concept.
However, evaluation of the procedure in clinical trials is
necessary, notes the editor of the journal, since the current
report doesn't included outcomes or safety data "to justify
widespread utilization of this technique."
SOURCE: BJOG: An International Journal of Obstetrics and
Gynecology, July 2008