"One of the things that makes a huge difference [to women] in how they experience a Cesarean birth, both in the short-term and long-term, is how they're taken care of during the labor process," said Pam Kane, a certified nurse-midwife with Penn Ob/Gyn and Midwifery. And that goes for everything from how involved she feels in major decisions about her labor to the specifics of her surgical environment. Dim lighting, in other words, may not have direct bearing on a newborn's health, but it can go a long way in making a new mother feel more present and comfortable during a profound, vulnerable moment in her life.

A primary area of focus for Gearhart's practice -- and for Pennsylvania Hospital -- is providing C-section mothers with the option of immediate skin-to-skin contact with their babies. Later this month, the hospital plans to launch a three-month pilot study among low-risk mothers who have scheduled C-sections in order to establish clear guidelines. Skin-to-skin contact sounds simple, but there are many issues hospitals must account for in the operating room. It requires, for example, that a dedicated nurse be present to help ensure the woman holds the baby safely while she still has IVs in and while her surgery is being completed. The sterile surgical field must be protected.

With traditional C-section practices, many patients "lose that sense of being a part of the birth because the baby is taken out, goes to a warmer, [and then] we do an assessment" said Ruth DiLeo, nurse manager of labor and delivery at Pennsylvania Hospital, who has helped spearhead the pilot program.

"This really changes things for patients, so there are just a few minutes when they're not able to hold their babies," she continued. "It really, for the patients, allows them to be much more a part of their birth than in the past."

Ultimately, the ongoing changes taking place in Pennsylvania speak to what childbirth educator Erica Lyon described as a surge of awareness in this country, within the last five years or so, about how important it is to make C-sections better for women. A team of labor and delivery nurses has devised a sterile drape that would make skin-to-skin easier to facilitate at many hospitals, and a growing number of facilities are offering what so-called "family-centered" Cesareans. That broader effort to improve the C-section experience, Lyon says, has also coincided with increased scrutiny of the high C-section rates in the U.S.

"Anybody who is for the physiological, psychological health of women is going to support [the idea] that we need to make surgical birth a better experience for women," Lyon said. "But that will only work if, in parallel, we are reducing the number of C-sections."

For Patel, a C-section was an absolute necessity. After several pregnancy losses, she had been diagnosed with an "incompetent cervix" that opened too soon. (In fact, she and Gupta had another daughter six months earlier via surrogate.) Because of her medical history, and because of her practical, scientific nature (she's a biomedical engineer), Patel's only focus leading up to her surgery was that her daughter was born healthy.

But at the same time, she and her husband cherish the small ways that their gentler Cesarean experience allowed the awe and wonder of childbirth to infiltrate the operating room.

"Sterility and infection control are paramount in any surgical procedure," Gearhart said. "But at the same time you've got this patient who is having this pivotal moment... and we're trying to bridge that gap."

"This is the birth of your child," Patel echoed. "Even if you are behind a sterile field, and you are going through major abdominal surgery, it's emotional."