Family Centered Cesarean is a term that is beginning to appear in many places on the Internet (you’ve seen the photos of Australian women pulling their own babies from their wombs during surgery, right?) and is just starting to cross the lips of many care providers. The name is somewhat self explanatory. We all know, on some level, what we mean by “family centered”. It means that the family is the focus. It holds a similar connotation to “student centered” when we are speaking of education. In a student centered classroom, the teacher focuses on what the students are excited by, uses teachable moments to create understanding, and keeps the learner in the spotlight. The opposing model, the “teacher centered” model, involves the teacher imparting information that they deem important, typically through lecture, while students sit quietly and take in the instructor’s great wealth of knowledge. This draws an easy comparison to “client centered” or “patient centered” health care. When care is client centered, the individual is treated as a unique person, their concerns are heard, they are treated holistically, and every effort is made to create a model of care that fits well with their preferences. When we talk about maternity care, instead of saying “client centered” we say “family centered” because in our realm, the entire family is a part of the plan of care. Not involving all members of the family and also including the newest member to be would be erroneous and contribute to an unsatisfying experience.
So then, what does it really mean to have a family centered Cesarean birth? While there are very specific ingredients that contribute to the family centered Cesarean, such as the lowering of the drape or lack of routine family separation in the immediate postpartum, the core of this practice remains the same as that of all client centered healthcare. The family is the focus. The family’s needs and desires are heard by the medical staff who then makes every effort to ensure that these preferences are met. The staff that provides family centered Cesarean understands that every birth is a momentous occasion, and that the need for a baby to be born surgically does not negate the need for the family to celebrate this wondrous time. I propose that the true definition of family centered Cesarean is essentially doing whatever it takes to ensure that the family has a fulfilling and satisfying Cesarean birth experience. While I have my own opinions on what is most important (skin-to-skin in the operating room, for example), my job is to understand what is most important to each family and provide it whenever possible. Only they know what is most meaningful to them and will bring them the most joy.
So, don’t feel like being able to reach down and pull your own baby out into the world is the definition of family centered Cesarean (even though that is really awesome). Families making their Cesarean birth their own and care providers supporting them is what defines a family centered experience.