Midwifery and birth, NHS

Birth by caesarean

I’m writing today about birth by caesarean . I want to try and make everyone who visits my blog arrive with an open mind and leave after reading it with a fresh perspective. 💭

“If we do what we have always done there is no change there is no development things stay the same” (by me 📝)

Operating theatres have to be sterile, organised and have processes for risk in place – safety is paramount . At the heart of the operating theatre is the patient – the staff do their job every single day it is a routine to them – running an infusion through, ensuring the sterility of instruments, making sure that the staff present are trained and that the correct checks have taken place. Al these things take place prior to the patient entering theatre.
I would like you to consider this – we come to work to do our job, we love our job and if not for the patient we would not have a job – do we see the patient as our employer ? In an indirect way the patient is our employer and yet simultaneously our customer . If our customer and employer has a good experience they will not always shout it from the rooftops as much as if they have a bad experience – so we must put this thought into our heads daily – a bad experience is more likely to be shared than a good experience.

As an independent human you access food, drink and warmth whenever you want it – you are thirsty so you get a drink you need food so you eat – if you ever become a patient the ability to do this stops or reduces – you cannot access food immediately, you have to ask for a warm drink and also you may have to ask to use the toilet 🚽. Your have to ask to satisfy your basic needs. These are some of the hard parts about becoming a patient – to access these things that you took for granted which you never considered you have to call another human by pressing a buzzer or asking permission. Add to this the fact that you may have had an operation or an illness which has compromised your ability to mobilise , access pain relief and compromised your high standards of hygiene . I’m not trying to influence your thoughts I just want you to think about these things.

Who does an NHS Women’s Unit theatre belong to ? In my eyes it belongs to Women so this means that NHS staff are the guardians of it . The theatre environment is very white bright and clinical because it’s always been that way – hang on “because it’s always been that way ?” Well let’s try to change that – why can’t we have paintings on the walls which are part of the wall ? imagine lying on a theatre bed staring into a blank void or imagine looking at a beautiful scene above you – which would you prefer?

A woman enters theatre knowing this will be the birthplace of her child. Her individuality has been removed by placing her into a generic gown removing her jewellery and make-up All the people in theatre will share the event of her child’s birth. The first thing that she sees are staff in pale blue gowns, masks and hats with only eyes peering out. The ability to communicate is lessened and there is a sense of stage and routine . Instruments on the trolley been arranged in place neatly ready for her operation to begin. If the woman is wheeled in she feels vulnerable and compliant on her hospital bed whilst others look upon her .


“All the world’s a stage,
And all the men and women merely players;
They have their exits and their entrances,
And one man in his time plays many parts,
His acts being seven ages. At first, the infant
William Shakespeare

We have one thing in common we are all born we all die . I am passionate that women who give birth in theatre either by Caesarean section or by forceps or ventouse are facilitated to feel as positive about their birth as women who give birth without intervention. I also want you to question your own units practices – do women who may require a manual removal of their placenta hold their babies routinely ? Do women who may have to have a repair of perineal trauma in theatre routinely hold their babies ?

The culture of the staff in the operating theatre is one of the largest barriers to skin to skin care taking place after a woman has undergone a Caesarean. Several clinicians have reported the implementation of immediate skin-to-skin care (within 30 minutes after birth) in their hospitals’ operating rooms (Smith, Plaat et al. 2008; Hung and Berg 2011) The authors noted that operating room staff members were initially skeptical, reluctant, and afraid to change their routine habits and behaviors. But after seeing the benefits of this family-friendly procedure, staff became supportive of the change
– read this link for further references http://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/

If every HCP in the theatre setting considered the promotion and facilitation of skin to skin in theatre as intrinsic part of their role – rates would soar and women and babies would be shouting from the rooftops . Patchiness is no good – just the other day I asked about the “Theatre list” and was sad to hear that two women and their babies did not have skin to skin discussed with them – Jenny The M can’t be everywhere – if only I could be like a fairy and zip into theatre with my wings and dust skin to skin thoughts on everyone around – imagine 💡.Read the following about cHange by Helen Bevan and Steve Fairman

NHS Change and transformation – Helen Bevan and Steve Fairman </a.

the NHS thrives on change it’s time to lose tradition and focus on the new – this is a slide I made for a presentation about optimal and appropriate use of an area – to do with Competence and the 6cs and it applies to any area involved in Women’s Health

It can be applied to the theatre setting and also to the process of skin to skin contact – so please please if you work in theatre and come into contact with a woman who may have to have a caesarean ask her if someone has discussed skin to skin contact and if they have not make it your goal to do this

Be rebellious for women out there – we are a crucial and core part of society and humankind – being rebellious for a woman’s cause shows courage and will have a profound effect on that persons life and first experiences.be a rebel
You might fear rejection but eventually you’ll get noticed and people will start to follow your lead and do the same 💡


I know where the skin to skin fairy lives



If you think you can’t make a difference just search #skinToSkin on twitter – 💕

Skin to skin


4 thoughts on “Birth by caesarean”

  1. Lovely piece Jenny! Great to get the theatre staff on board – once they understand the importance of a newborn being skin to skin with her/his mother, they are very helpful. One thing I did in our tertiary referral hospital was do multiple presentations, complete with groovy PowerPoint ‘show and tell’ at theatre staff’s handover times, including night shift, helping them to understand the neuroscience and psychophysiology of the process – they became very amenable to supporting the mother and her newborn.


  2. Hello. I have recently had an emergency caesarean and whilst it was a very scary experience for both myself and my partner the care was fantastic. My birthing plan was all natural hypnobirthing until undiagnosed placental previa changed the plans. As sterile and clinical the operating theatre was everybody took there time to introduce themselves to me as they completed there preoperative tasks. I will always miss the birth which I had imagined however the care and support I received ensured it became a happy memory. #skinToSkin was encouraged (even though I had already discussed I wanted skin to skin and to breastfeed as soon as possible) Due to complications of my part of the operation skin to skin was delayed, however my partner was able to skin to skin whilst I was still preoccupied. When baby was able to snuggle down onto me around two hours after the birth it was a magical time for both of us, baby knew what to do and what to look for ( a fear my post caesarean mindset thought would be an issue) the conversation with my midwife reassured me that everything will be alright as baby knows what to do. I share my experience to strengthen the understanding and importance of #skinToSkin to both mother and baby. The bonding I missed by not witnessing the actual birth was soon made up for by the cuddles and contact within the emergency room. This bond grows daily during the plentiful feeds we both share. ☺


  3. great post.
    I have to say it brought back a lot of memories of my planned c-sec. It also brought up feelings I didn’t really realise I had. I felt that fear and helplessness I had at the time, this was of course quickly over run once I heard the cry of my baby and knew he was okay. However the blankness and definitely feeling like a blank slate with no personal touch are feelings I didn’t really realise I felt until I read this and found myself nodding along!!!


  4. I’ve had 4 very different c sections now. My first was an emergency, but relatively calm. I felt at ease, happy and relieved after a pretty miserable induction. I was happy to hold my baby once i’d been stitched and never questioned anything at all. My second emergency section was horrific. I was put to sleep without explanation and woke up to find my baby had been delivered, resuscitated, cleaned, wrapped, weighed and named. I struggled to even accept he was mine. It was awful and we struggled to bond.
    My third section was an elective and a wonderfully peaceful experience. My one, true positive birth. And although my 4th was also a planned section, it wasn’t elective because it wasn’t what I wanted. I wasn’t in control. There was fear right up to the moment I heard her cry. And I wish that I’d known it was possible to fight a little harder to hold her in the theatre. I waited until recovery BUT I did get skin to skin, for the frst time ever. It so hard to explain how it feels to walk into the theatre, with all the eyes looking at you and the atmosphere. The staff did make attempts to put me at ease but its hard to feel like a person when you’re lying there on the table. I’m thankful for the fact that my life has been saved twice, and my babies are here to tell the tale 🙂 x x x x


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