Avoiding a Cesarean

A high percentage of cesareans done in the United States are medically unnecessary, therefore many are preventable. There are measures that can be taken to help possibly avoid an unnecessary cesarean. However, clearly there are times when cesareans are very necessary, such as instances of a prolapsed cord, placenta previa and uterine rupture, which would all lead to an emergency c-section to save the lives of the mother, baby or both.

Become Cesarean Educated

During your pregnancy, attend childbirth classes. This may allow you to talk with others who have been there and may also give you many great coping skills for labor to increase your comfort and decrease the need for medications and intervention. Read and learn as much as you can about the birth process, all of your birth options and what to expect during labor, which may help you to appropriately express your choices for birth to your doctor or midwife. When choosing a doctor or midwife, interview more than one and ask lots of questions, including what their philosophy is on cesarean birth. Ask them what their “primary cesarean rate” is in their practice. The number should preferably be no more than 10%. Ask them if there is a time limit for labor and the pushing stage and also ask what they feel can interfere with the normal labor process. If you’ve had a previous c-section, be sure to ask about the possibility of a VBAC (vaginal birth after cesarean).

Delivery Options

Once you choose a doctor or midwife, discussing your delivery wishes early on is extremely important. Preparing a flexible birth plan is also very helpful and important. After researching and creating a birth plan, make copies and give them to everyone who will be involved in your labor and delivery, including your labor support people, your doctor or midwife, as well as the hospital or birth facility. Discuss it extensively with your doctor or midwife and share your goal of avoiding a cesarean birth unless absolutely necessary.

Choose a labor support person, such as a doula (an experienced labor companion who provides continuous emotion support and information during labor and delivery) . Cesarean rates for women who choose professional labor support are significantly lower. Professional doulas are trained in the ways of labor support using massage, relaxation (including aromatherapy), coping techniques and physical comfort measures.

Labor Induction

If possible, try to avoid an induction of labor, which can lead to an increased risk of needing a cesarean. For a labor that is progressing slowly, try other things such as nipple stimulation instead of Pitocin for augmentation. Explore your pain relief options. Epidurals and other anesthesia can slow down labor progression (especially if done too early during labor). With the use of an epidural, you cannot walk, therefore you can’t use gravity to help labor along and also because of the numbness, you may have trouble pushing effectively. If you feel the need for an epidural, wait until you are past 5 centimeters, if possible, and in active labor.

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