Cesarean Prevention

by Kara Maia Spencer, LMT, CD, www.MaiaHealingArts.com 

A Cesarean section is  major abdominal surgery performed in order to deliver a baby from its mother, through an incision in her abdomen. Cesarean's are a vital emergency surgery for mothers and babies who are at severe risk. However, C-sections are on the rise in US and around the world, and it is reaching epidemic proportions. In the 1960's, only 5% of babies were born by Cesarean, in the 1970's and 1980's the surgery increased to 25% of women delivered their babies through surgery. Now, in the US, one in three women deliver their babies via Cesarean.

 Your having a baby and you want to avoid a C-section - what do you do? The best thing you can do to reduce the risk of Cesarean is to hire a midwife for your prenatal care, labor, and delivery. Midwives have dramatically higher rates of successful healthy vaginal delivery that obstetricians. A new research study by Sutter Health, shows that the two factors in hospital birth that most lead to a Cesarean are active management of early labor and medical induction.

 You can avoid active management of early labor through hiring a doula to support you through labor. A doula can come to your home in early labor, and is familiar with signs and behaviors of the different stages of labor, and may help you to cope at home, so you don't show up at the hospital too early. Try to stay at home until you are in active labor to avoid unnecessary interventions which may lead to iatrogenic complications.

 Increase your awareness of the realities of medical induction. Along with Cesareans, there is an epidemic of inductions happening in the United States. The baby's due date is an estimated due date, yet there is increasingly a medical and cultural belief that babies should be born on or by the due date. In fact, only 4% of babies are born on their estimated due dates, and most first time moms go about a week over due. Also, due dates can be tricky to calculate due to variations in women's menstrual cycles and the timing of ovulation. The Lamaze Institute for Normal Birth has a position paper on inductions, which I feel is a must-read for pregnant women. At one of my local hospitals, 70% of women who are medically induced end up delivering via Cesarean section.

Also, choose your place of birth carefully. Midwives have lower c-section rates than doctors. Non-profit hospitals have lower c-section rates than for-profit or teaching hospitals. In Seattle, the non-profit Group Health has a c-section rate of 16%, while the nearby profit and teaching hospitals have c-section rates of 36%! Cesarean surgery is a hugely profitable industry, and 80% of cesareans happen Monday through Friday between 8 am and 5 pm. While surgery may be more convenient for the doctor, the increased risks are not convenient for mom and baby.

Education increases your chances of a healthy informed birth. Hire a midwife, a doula, make informed choices, and trust in your body and your baby! Research and practice techniques for optimal fetal positioning, to encourage your baby to be in the best position for  labor and birth. For more resources on Cesarean awareness and prevention, check out the ICAN website of the International Cesarean Awareness Network.