Clear-drape cesarean section now an option at N.C. Women's Hospital

The clear-drape cesarean section is part of an emerging birthing trend called family-centered cesarean, which allows the family to have a more active role in childbirth, even when that birth comes via surgery.

Clear-drape cesarean section now an option at N.C. Women's Hospital click to enlarge Dr. Sarah Dotters-Katz, midwife Meg Berreth and Dr. Emi Bretschneider deliver baby Bailey Dawes as mom Tabitha watches. (Photo courtesy of Manda's Memories by Raleigh Birth Photography)
Clear-drape cesarean section now an option at N.C. Women's Hospital click to enlarge Shayne and Tabitha Dawes hold new baby Bailey. (Photo courtesy of Manda's Memories by Raleigh Birth Photography)

With each of her four pregnancies, Tabitha Dawes had hoped for the chance to experience low-intervention, natural childbirth – the kind she often assists in her career as a birth doula.

Each time, for her health and the health of the baby, she would need a cesarean section. Not being able to reach her goal of a natural childbirth left her feeling deflated, and she had approached each operating room full of anxiety and worry.

But on July 14 when she arrived at N.C. Women's Hospital for her fourth cesarean section, she was excited and hopeful.

Thanks to an enterprising suggestion Dawes made at a prenatal appointment, and an interdisciplinary delivery team who worked to make it happen, her quest for a better birth experience was within reach.

The lights in the operating room were soft. Music played. And, at the time of delivery, the blue surgical cloth that separated her from the procedure was lowered and replaced with a clear drape.

Dawes's procedure was the first of its kind at N.C. Women's Hospital. The clear-drape cesarean section is part of an emerging birthing trend called family-centered cesarean, which allows the family to have a more active role in childbirth, even when that birth comes via surgery.

Through the drape, Dawes could see the smiles of the obstetrician, midwives and nurses behind their surgical masks, and then she saw her daughter Bailey's very first moments of life as she was lifted before her eyes.

A nurse then placed Bailey on her mother's chest for immediate skin-to-skin contact, an important practice research has shown beneficial for both mom and baby and which clinicians at UNC have recently begun offering at cesarean section births, as well.

"You'd think that after three c-sections, I'd be used to it, but no. I still had a lot of anxiety leading up to it," said Dawes, "but just knowing that they understood how I felt and they wanted to make it better meant everything to me."

Though birth teams at the hospital had been exploring the possibilities surrounding family-centered cesarean sections, it was Dawes who brought the first one into being. After learning she would not be able to deliver Bailey naturally, she researched ways to improve the surgical birth experience and learned about clear-drape procedures.

Six weeks from giving birth, she brought it up with her midwife, Jenny Cox.

"I wanted to be more of a part of this baby's birth, and I wanted to get to see what I felt like I'd missed out on," said Dawes. "I asked, 'Can we make this more of what I want?' and Jenny said, 'let's see.'"

Cox consulted Dr. Sarah Dotters-Katz, a fellow in UNC's division of maternal-fetal medicine. As they pondered the possibilities, they assembled a team to find an answer, engaging nursing and anesthesiology staff in the conversation.

For Dr. Dotters-Katz, being part of the best day of someone's life is one of the best parts of her job.

"We try hard with every patient, but when someone has had a previously bad experience, you go the extra mile," she said.

Once Dr. Dotters-Katz heard Dawes's story, she wanted this delivery to be one of those best days. So did Emily Jackson, the nurse manager for labor and delivery. And, Jackson said, so did everyone involved.

"It is much more rewarding to put in a little extra effort and see the difference we can make for our patients. I've always believed that birth is an experience, not a procedure. I love that the entire team at UNC is dedicated to providing a positive birth experience in addition to positive outcomes," said Jackson.

As a birth doula, Dawes has assisted more than 30 births. From her perspective, cesarean deliveries kept her from being able to fully experience childbirth – so the team worked to change that perspective.

"We wanted to make it special, an experience she wanted instead of feared, and I wanted to be able to do everything that was possible," said Dr. Dotters-Katz. "And," she said, "It was so much fun for us to watch her watch her baby be born."

Gathering support from all clinical parties who would be involved with Dawes' procedure was important – from midwifery and obstetrics to nursing and anesthesiology. Jackson said she felt lucky to be part of a team that was committed to providing a great birth experience, when it might have felt easy to avoid a new way to do a common procedure.

The team made a difference to Dawes, because, from the start, she was on that team, too.

"I learned that at UNC, how you give birth – even when you need a cesarean section – can be an open conversation. As a mother, that changed how I viewed the experience. It becomes something you are part of and that you choose, rather than something that's done to you."

If patients wish to be part of a family-centered cesarean at UNC, it's something they should address with their provider ahead of time, if possible, said Dr. Dotters-Katz. "Tabitha brought her ideas to labor and delivery, and I felt lucky to be able to have this experience with her."

With every birth, the first goal is to make sure safety isn't compromised, she said. But a clear-drape cesarean section is great for a patient who is interested in a more intimate experience than is typical of an operating-room birth.

"It was a success because we had such a great team working together – nurses, anesthesiologists, midwives, maternal-fetal medicine, obstetricians," she said. "But, ultimately, it's a successful event because of great outcome – a happy mother and a healthy baby."


Photography courtesy of Amanda Ditzel at Raleigh Birth Photography


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