What the research shows

About one in three babies in the United States is born by C-section. For most of medical history, that mode of delivery was treated as neurologically equivalent to vaginal birth. We now know it isn't.

Studies show that infants born by elective C-section — particularly without the labor process — exhibit measurably lower catecholamine levels at birth (Otamiri et al., 1991, 1992). Catecholamines are stress hormones the baby's body produces during the labor process. They prime the lungs to expand, kickstart the stress-response system, and signal to the nervous system that the world is real and the body is alive. Without that hormonal surge, certain neurological transitions happen more slowly.

The proprioceptive squeeze of vaginal birth — the rhythmic compression of the chest, the vestibular tumbling through the birth canal, the deep pressure on the skin — is itself a sensory event. It primes the autonomic nervous system. It calibrates early reflexes including the Moro reflex.

Longitudinal data confirm this pattern. Infants born by prelabor cesarean section show lower developmental scores at 3 to 12 months of age, particularly in motor domains (Zaigham et al., 2020). Children born by C-section show modestly elevated odds of developmental delay at age 3 (Sznajder et al., 2020).

What this looks like in our Brewer clinic

I see this pattern often. A child comes in with:

• Sensory processing differences — over- or under-responsiveness to touch, sound, or movement
• A retained Moro reflex that should have integrated by 6 months
• Motor delays — especially with anti-gravity movements like crawling and walking
• Sleep dysregulation
• Difficulty with transitions, big emotions, or feeding

When I take the birth history, more often than not the child was born by C-section — often emergency or prelabor cesarean. This isn't every C-section baby. And it doesn't mean every C-section causes problems. But the correlation is real, and it shows up in the assessment.

What we do in the clinic

For C-section babies and children showing retained primitive reflex patterns, our protocol typically includes:

• Rhythmic developmental movement — patterned vestibular and proprioceptive input that signals safety to the brainstem and supports reflex integration
• Deep pressure protocols — replicating the sensory priming of vaginal birth through compression, brushing, and weighted input
• Tummy time progression — even with older children, we revisit foundational positions to rebuild what may have been skipped
• Parent coaching — because you are the most important sensory experience your child has every day

Read more about retained primitive reflex integration →  |  Read: Why your child startles, panics, or spirals over nothing — the retained Moro reflex →

OT-recommended tools for early sensory priming

Tools we recommend for families wanting to support a nervous system that may have missed some early sensory input:

• Weighted blankets & compression vests — deep pressure that primes the parasympathetic system
• Sensory swings — slow vestibular input that calibrates the inner ear
• BrainMax Sensory Putty — proprioceptive hand input the somatosensory cortex needs to build a clear body map
• Home sensory gym pieces — for the rhythmic, weight-bearing movement that integrates early reflexes