Considerations for an Empowered C-Section
- Alex Kelly
- Nov 20, 2025
- 9 min read
A 2022 PubMed review reports that up to 45% of new mothers experience childbirth-related trauma. I’m one of them. My first birth was an unplanned, deeply traumatic c-section that took years and counseling to heal from. A few years later, I had a redemptive home birth VBAC with two amazing midwives, Teri and Amber.
It IS possible to have an empowering c-section.
Birth is empowering when a mother feels respected, informed, and included in every decision, no matter how the baby comes into the world. The real questions are always the same:
Was she respected?
Did she have autonomy?
Did she understand what was happening?
Was it necessary?
When the answer is yes, a c-section can be just as meaningful and joyful as any other birth.
It is important to note that babies born surgically do miss some natural processes of vaginal birth, but there are ways to support their health and development afterward. My hope is to encourage moms that they can have an empowering experience and give their baby the best start possible.
A huge thank-you to my incredible midwife, Teri, for sharing her knowledge. There’s truly no one more passionate about advocating for women and babies.
Hire a Doula
Many people think doulas are only for unmedicated and vaginal births, but that couldn’t be further from the truth. Doulas are powerful advocates for any mom, and c-section moms especially. A doula’s role is to support, guide, and protect the mother’s experience.
Even in the operating room, you can still hold onto many of the hopes you had for your birth; for example, playing your birth playlist during the procedure. Your doula is there to help ensure your wishes are heard, honored, and respected every step of the way, allowing you to focus fully on meeting your baby.
While having a doula gives your partner the freedom to focus solely on supporting you, if a doula isn’t in the budget you can appoint your partner to be your advocate if you are unable to advocate for yourself. Just keep in mind that, in many hospital settings, they may need to step into a firmer “bad guy” role at times. You can also consider bringing a trusted friend or family member who feels comfortable with clear and confident communication.
Know This "Magic Phrase"
“I. DO. NOT. CONSENT.”
This is the magic phrase to get any hospital personnel to stop what they’re doing immediately. Do not be wishy washy with phrases like “I don’t really want to,” or “do we have to do that?”
Instead, ask the following questions to make sure you are fully informed:
Am I in danger?
Is the baby in danger?
Is this an emergency?
If the answer is no, then an acceptable response is, “I do not consent. Can we please have a few minutes to discuss?” Again, this is another great benefit of having a doula - someone who can be a sound and expert mind once the doctors leave the room.
Most c-sections are NOT an emergency, even if they’re unplanned. When it’s a true emergency it’s obvious. There will be a flood of people and minimal conversation as mom is being rushed to the operating room to be put under general anesthesia, if an epidural is not already placed.
This magic phrase is still applicable after baby is born. Nurses trying to give baby vitamin K, eye ointment, or any other procedure you aren’t comfortable with? Instead of saying, “not right now,” or “I don’t think I want to do that,” be firm and confident: I. DO. NOT. CONSENT.
60 Second Delayed Chord Clamping
During a c-section, the safest limit for delayed chord clamping is 60 seconds since the abdomen is open and infection risk increases with time. However, you have every right to insist on 60 seconds. This minute still makes a huge difference. Research shows that roughly 80% of the blood that transfers to the baby through delayed clamping arrives within that first minute. While it’s not a perfect scenario, it’s still a highly beneficial one.
Advocate for Baby's Handling
It’s wild this even has to be advised, but another benefit of having a doula is having someone in the OR who can advocate for how your baby is being handled immediately after delivery.
As soon as baby is born, they are going to be received by a sterile baby nurse and taken to a warmer. And the way newborns are handled following a c-section is alarming. There is often no regard to them being a human being. They are jostled, vigorously rubbed, and handled with very little care. If you want your partner to stay with you, it's advised to have another support person to go with baby to the warmer.
This designated person can stay with your baby every step of the way, speaking to them, using their name, and offering comforting, human connection. They can also help ensure your baby is handled gently, request that routine newborn procedures be paused if your baby is stable, and make sure your baby is brought to you as soon as possible.
Skin to Skin in the OR
While a little tricky, skin to skin in the OR is possible. Ideally, baby would come immediately over the drape onto mom’s chest, but this is not realistic. The drape is typically right under moms breast, so what usually happens is baby is swaddled and put cheek to cheek with mom. This is not skin to skin. Baby needs to be unswaddled down to the diaper and put directly onto as much as mom’s skin as possible.
There will need to be a person who stands right there with mom and keeps a hand on baby at all times, whether it be dad or another support person like a doula.
IF YOU DON'T WANT IT, IT'S OKAY!!!!
Please hear me say, if you do not want baby on you while you are being sewn up that is okay! You are in the middle of major abdominal surgery, and it’s normal to feel overwhelmed and overstimulated. I lived with years of guilt for not wanting my son anywhere near me while I was being sewn up, and all I needed to hear was someone tell me “it’s okay!”
So here it is for you, IT’S OKAY!
If you find yourself in the latter situation, have your baby swaddled in a warm blanket. As soon as surgery is over, unswaddle your baby and place them skin to skin, chest to chest, while being wheeled back to the recovery room.
Vaginal Seeding: what the heck is it?
Vaginal seeding is a practice where a baby born via cesarean is exposed to the mother’s vaginal fluids shortly after birth, usually via swabbing a Q-tip or gauze in the baby's mouth and nose.
Some moms choose to do this to give their baby the beneficial bacteria they would have received during a vaginal birth, which may help support gut health and immune development.
This may help explain why children born via cesarean section have a higher likelihood of developing eczema compared to those born vaginally. It can also feel like a way to provide a connection to the birth experience.
Vaginal Seeding: how to do it
For families who want to explore vaginal seeding, it’s something parents will need to do independently. Hospitals won’t facilitate, and you don’t need permission. In fact, Teri discourages even asking.
Simply insert a sterile gauze into the vagina about an hour before a planned c-section, or wipe the vaginal area with it if you are in labor and about to have an unplanned c-section. Before surgery, remove the gauze and place it in a sterile container like a zip-lock bag.
Once you are alone in your recovery room, grab the gauze and wipe the inside of your baby’s cheeks and nose, mouth, face, and the rest of their body.
Vaginal Seeding: HSV and GBS+
A few caveats:
If you have HSV, it’s advised to refrain from seeding. If you have been on suppression therapy, and don’t have signs or symptoms of an outbreak that could be looming, then you’d probably be fine - but that’s a decision you’d have to make on your own weighing the risks and benefits.
Another reason to have pause when it comes to vaginal seeding is if mom is GBS+. Again, you will have to weigh the risks and benefits and make that decision for yourself. If you do decide to seed you, at least, need to make sure you collect your q-tips after receiving antibiotics in the hospital.
Pain Management: anesthetics
When it comes to pain management, get on a schedule. Don’t wait until you’re in pain. Pain management plays a major role in how empowered and capable a c-section mom feels after birth.
In some parts of the country there is a long-acting local anesthetic called Exparel a surgeon can use at the site of the c-section, and lasts about three days.
There’s another called an OnQ pump, which is basically a bulb of pain medication with a tiny tube that goes into the surgical site under the incision and constantly bathes the area with local anesthetic.
Both of these can greatly improve mom’s recovery, and reduce the amount of oral narcotics.
Pain Management: get on a schedule
Most times strong narcotics are used at the hospital, and then mom is discharged with just Motrin and Tylenol. But you can also advocate for a Gabapentin (non-narcotic nerve pain medication) prescription when you leave the hospital.
Regardless, get yourself on a scheduled regiment of Tylenol, Motrin, and Gabapentin (if applicable), to get you through the first week.
I am not one to typically recommend Tylenol, but listen…you just had MAJOR abdominal surgery. Do what you need to do to rest, take it easy, bond, and enjoy your newborn.
Additionally, c-section moms are at a higher risk of developing blood clots in their legs if they have prolonged immobility. As uncomfortable as it may be, it’s critical to get in some movement, so having a good pain management system will allow you to be up and mobile to reduce the risk of blood clots.
Bodywork for Newborns
This next section was collaborated with Dr. Madison Mastro, an amazing Webster certified, craniosacral chiropractor.
You will often hear the term “bodywork” when it comes to pregnant women and newborns. Bodywork is simply a broad, umbrella term for any hands-on technique that helps release tension, improve movement, or support the nervous system. It isn’t one specific treatment.
Under this category you’ll find approaches like chiropractic care, craniosacral therapy, infant massage, myofascial release, and physical therapy. There’s a time and place for all of the above, but chiropractic care and craniosacral therapy can be especially helpful for newborns, particularly c-section babies.
Bodywork for C-Section Babies
During a vaginal delivery, the natural compression and decompression of the birth canal helps shape the skull, mobilize the spine, clear fluid, and reset the nervous system.
C-section babies do not experience this process and may have subtle tension in the head, neck, or spine. Positioning in the womb and the way babies are lifted during surgery can also contribute to tight muscles, head preferences, congestion, or difficulty settling.
Bodywork, such as craniosacral therapy or gentle chiropractic care, can help by restoring normal motion in the spine, releasing tension in the head, jaw, neck, and connective tissues, and supporting the nervous system. This support can make feeding easier, help babies turn their heads evenly, aid digestion, improve sleep, and increase overall comfort as they adjust to life outside the womb.
An Important Note on TONGUE TIES
I’m adding this blurb because the tongue and lip tie world has grown rapidly in the last few years, and with that growth has come a lot of concerning misinformation and poor care. It is frustrating to hear how often families are led astray - not out of malice, but because many providers are simply grossly uniformed and uneducated.
If, at any point, you are given a tongue tie diagnosis...STOP!!!!
First, you need to make sure you are being diagnosed by a properly trained AIRWAY DENTIST (some IBCLC’s are able to pretty accurately diagnose, but they can’t release). I cannot tell you how many providers make a diagnosis who have absolutely no idea what they are doing. Second, you should NOT move forward with a release unless you have seem both an IBCLC and craniosacral therapist (specifically CST for tongue ties). If your diagnosing provider is not recommending either of these, it’s time to find a new provider.
C-Section Scar Care
For my c-section, I wore “depends” the first few days (you will still have vaginal bleeding pp), then switched to high-waisted underwear. I would place the sticky part of large pads on the inside of the depends and underwear so that the pad part was resting over and protecting my scar.
A belly-binder was also very helpful, and made me feel more secure and protected. The hospital should provide you this. They will also provide you depends and pads, unless you prefer to bring your own.
My first delivery I was induced at 38 weeks due to pre-eclampsia, had a “failed” induction, and an unplanned c-section. I since learned it was NOT a failed induction, and the c-section was NOT necessary. OB/hospital bullying at it’s finest.
I knew I wanted something different for my second, so I went the midwife route. I was actually planning a hospital birth with Teri up until my 3rd trimester, when I decided to switch to a home birth (with Teri).
Best. Decision. Of. My. Life.
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