Things You Can Do To Avoid A Cesarean
This was published by ICAN:
The Public Citizen Health Research Group in Washington, D.C. has estimated that half of the nearly 1 million cesareans performed every year are medically unnecessary. With more appropriate care during pregnancy, labor, and delivery, half of the cesareans could have been avoided. Clearly, there are times when cesareans are necessary. However, cesareans increase the risk to both mothers and babies. These are suggestions of things you can do to avoid an unnecessary cesarean and can help insure that your birth experience is as healthy and positive as possible.
BEFORE LABOR
Read and educate yourself, attend classes and workshops inside and outside the hospital.
Research and prepare a birth plan. Discuss your birth plan with your midwife or doctor and submit copies to your hospital or birth center.
Interview more than one care provider. Ask key questions and see how your probing influences their attitude. Are they defensive or are they pleased by your interest?
Ask your care provider if there is a set time limit for labor and second stage pushing. See what s/he feels can interfere with the normal process of labor.
Tour more than one birth facility. Note their differences and ask about their cesarean rate, VBAC protocol, etc.
Become aware of your rights as a pregnant woman.
Find a labor support person. Interview more than one. A recent medical journal article showed that labor support can significantly reduce the risk of cesarean.
Help ensure a healthy baby and mother by eating a well-balanced diet.
If your baby is breech, ask your care provider about exercises to turn the baby, external version (turning the baby with hands), and vaginal breech delivery. You may want to seek a second opinion.
If you had a cesarean, seriously consider VBAC. According to the American College of Obstetricians & Gynecologist, VBAC is safer in most cases than a scheduled repeat cesarean and up to 80% of woman with prior cesareans can go on to birth their subsequent babies vaginally.
DURING LABOR
Stay at home as long as possible. Walk and change positions frequently. Labor in the position most comfortable for you.
Continue to eat and drink lightly, especially during early labor, to provide energy.
Avoid pitocin augmentation for a slow labor. As an alternative, you may want to try nipple stimulation.
If your bag of water breaks, don’t let anyone do a vaginal examination unless medically indicated for a specific reason. The risk of infection increases with each examination. Discuss with your care provider how to monitor for signs of infection.
Request intermittent electronic fetal monitoring or the use of a fetoscope. Medical research has shown that continuous electronic fetal monitoring can increase the risk of cesarean without related improvement in outcome for the baby.
Avoid using an epidural. Medical research has shown that epidurals can slow down labor and cause complications for the mother and baby. If you do have an epidural and have trouble pushing, ask to take a break from pushing until the epidural has worn off some and then resume pushing.
Do not arrive at the hospital too early. If you are still in the early stages of labor when you get to the hospital, instead of being admitted, walk around the hospital or go home and rest.
Find out the risks and benefits of routine and emergency procedures before you are faced with them. When faced with any procedure, find out why it is being used in your case, what are the short and long term effects on you and your baby, and what are your other options.
Remember, nothing is absolute. If you have doubts, trust your instincts. Do not be afraid to assert yourself. Accept responsibility for your requests and decisions.
This may be copied and distributed with retained copyright.
© International Cesarean Awareness Network, Inc. All Rights Reserved.
The Public Citizen Health Research Group in Washington, D.C. has estimated that half of the nearly 1 million cesareans performed every year are medically unnecessary. With more appropriate care during pregnancy, labor, and delivery, half of the cesareans could have been avoided. Clearly, there are times when cesareans are necessary. However, cesareans increase the risk to both mothers and babies. These are suggestions of things you can do to avoid an unnecessary cesarean and can help insure that your birth experience is as healthy and positive as possible.
BEFORE LABOR
Read and educate yourself, attend classes and workshops inside and outside the hospital.
Research and prepare a birth plan. Discuss your birth plan with your midwife or doctor and submit copies to your hospital or birth center.
Interview more than one care provider. Ask key questions and see how your probing influences their attitude. Are they defensive or are they pleased by your interest?
Ask your care provider if there is a set time limit for labor and second stage pushing. See what s/he feels can interfere with the normal process of labor.
Tour more than one birth facility. Note their differences and ask about their cesarean rate, VBAC protocol, etc.
Become aware of your rights as a pregnant woman.
Find a labor support person. Interview more than one. A recent medical journal article showed that labor support can significantly reduce the risk of cesarean.
Help ensure a healthy baby and mother by eating a well-balanced diet.
If your baby is breech, ask your care provider about exercises to turn the baby, external version (turning the baby with hands), and vaginal breech delivery. You may want to seek a second opinion.
If you had a cesarean, seriously consider VBAC. According to the American College of Obstetricians & Gynecologist, VBAC is safer in most cases than a scheduled repeat cesarean and up to 80% of woman with prior cesareans can go on to birth their subsequent babies vaginally.
DURING LABOR
Stay at home as long as possible. Walk and change positions frequently. Labor in the position most comfortable for you.
Continue to eat and drink lightly, especially during early labor, to provide energy.
Avoid pitocin augmentation for a slow labor. As an alternative, you may want to try nipple stimulation.
If your bag of water breaks, don’t let anyone do a vaginal examination unless medically indicated for a specific reason. The risk of infection increases with each examination. Discuss with your care provider how to monitor for signs of infection.
Request intermittent electronic fetal monitoring or the use of a fetoscope. Medical research has shown that continuous electronic fetal monitoring can increase the risk of cesarean without related improvement in outcome for the baby.
Avoid using an epidural. Medical research has shown that epidurals can slow down labor and cause complications for the mother and baby. If you do have an epidural and have trouble pushing, ask to take a break from pushing until the epidural has worn off some and then resume pushing.
Do not arrive at the hospital too early. If you are still in the early stages of labor when you get to the hospital, instead of being admitted, walk around the hospital or go home and rest.
Find out the risks and benefits of routine and emergency procedures before you are faced with them. When faced with any procedure, find out why it is being used in your case, what are the short and long term effects on you and your baby, and what are your other options.
Remember, nothing is absolute. If you have doubts, trust your instincts. Do not be afraid to assert yourself. Accept responsibility for your requests and decisions.
This may be copied and distributed with retained copyright.
© International Cesarean Awareness Network, Inc. All Rights Reserved.
Replies to This Discussion
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Permalink Reply by Selena on -
Hi Denise, I feel your pain! I also believe that I had a unnecessary c-section like you did for failure to progress. I did not want to have major surgery. I had gone 5 days past my due date with no dilation at all and I let them induce me. I made it to 9 cm...9! and stopped there for 3 hours. My dr came in and said "we need to just go ahead and do a c-section, it's been long enough". I was devastated to say the least. Like you, I didn't do enough research and I have blamed myself. I didn't get to hear my baby cry and didn't breastfeed because I was so drugged. Please know that you are not alone with your feelings! :) Drs don't think it is a big deal since mother and baby are fine but there is an emotional side of it they don't think about.
Denise said:Ifeel as though...strike that....I know that I had an unnecessary c-section and I am hurt/devastated/and angered about it. My water broke naturally and I didn't dialate right away. I had every known intervention done to my body. I feel aweful that I allowed interventions to be performed on my body. I labored at 2-3 cm for about 31hrs until the Drs said that I had to have a c-section becuase I had failed to progress. Neither I nor my baby were in distress. I wish that I had done more research prior to delivering. I even had a midwife with me during my labor however she was the one who was also pushing the c-section in addition to the Drs! I was tag teamed and couldn't defend myself at that moment. I felt for so long that my body failed me but now I know that the medical staff at the hospital failed to support my request for a natural delivery.
Next time around I am ademant that I will not accept any interventions that my actually stall may labor (such as an epidural). My only concern about not going to a hospital to deliver is if I have uterine rupture. I heard that you can have an ultrasound which will measure your c-section scar tissue. I still need to research this more but apparently the thinner your scar the higher chance that you may have uterine rupture. I am doing to demand that I have this assessment performed...perhaps even before I become pregnant so that I do not need to worry about it as much during my pregnancy.
Also I would like to mention a rather interesting piece of information that my OB/Gyn told me at my follow up appointment - the next time I get pregnant they will not be able to use Pitocin on me becuase it has shown to increase chances of uterine rupture. At least I will not have to worry about being induced! BUT she did say that if I do not go into labor prior to my due date than I will HAVE to have a c-section (so she thinks). Why on earth would I schedule major abdominal surgery around an estimated due date? I don't want to be a difficult patient but I will not merely go along with what people tell me because it is my body, my baby and my birth experience. That I will not budge on.
Thank you for posting this information. I will add it to my 'file' of information that I am gathering.
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