Gentle C-Section, with OB, Andy Simm

Caesareans are often feared by women going into birth, but there's a new trend coming through that could hope to reduce that somewhat. The gentle c-section otherwise known as the natural caesarean is a much softer approach than the usual surgical ritual.



To help explain what a gentle c-section is I'm being joined by OB Andy Simm from Nottingham City Hospital (my local!). It is Andy who was the OB behind the gentle c-section positive birth story that I shared last season. He's a bit famous around my neck of the woods!

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What is a gentle c-section?
In a gentle c-section, or natural caesarean, the drapes which normally screen the operation from the mother are lowered – so she (and her partner) can actually see the baby being born. The baby is also given time to “wriggle out” of the womb, rather than being instantly lifted out by the obstetrician. The newborn is then placed on the mother’s chest for her to hold, cord intact, instead of being whisked off for weighing and measuring.

To help the mother to have some skin to skin, the ECG wires are taped to her back which means that she is more likely to be able to breastfeed straight away.

All this is quite a departure from what we know c-sections to be like, but it doesn't stop there. A gentle -c-section is also one where the environment of the operating theatre is tweaked to help make it more friendly... lower lights basically!

This women-centred approach has many reported benefits for mother and baby including: improved breastfeeding rates; a better birth experience; increased bonding due to instant mother and baby skin to skin contact; plus reduced risk of lung issues as the extra time allowed pressure from the uterus  to expel liquid from baby's lungs.

Of course, a natural caesarean is not drug-free or risk free – but local anaesthesia is carefully used to ensure the mother is alert and able to hold her baby. This is HUGE!

During our chat we identified a gentle c-section checklist that you can use as part of your birth planning;

lighting and environment (music)
let baby wriggle out on their own
skin to skin
delayed cord clamping
birth narration
seeding the microbiome

About Andy Simm
Andy Simm has worked as a Consultant Obstetrician in Nottingham for 15 years, with interests in diabetes and endocrine disorders in pregnancy and fetal growth disorders. He has a keen interest in management of labour where this deviates from the norm, and promotes the importance of communication, team work and other non technical skills. This has been recognised with both awards from within the Trust and nationally.
Andy has a large obstetric clinical practice, and as College Tutor is responsible for the overall quality of education and training of junior doctors within his unit.
Most recently he has become involved in undertaking the ‘gentle’ caesarean section, with video footage posted on social media websites getting 10 million hits. ‘Gentle’ caesarean is undertaken in a softer environment, with a slower delivery that facilitates autoresuscitation of the baby, namely expulsion of fluid from the fetal lungs, and a gentle transition to breathing in air by undertaking deferred cord clamping. Women are enabled to watch the birth if they wish, and immediate skin to skin contact is facilitated. Demand for the procedure is increasing