7 Ways to Minimize Your Chances of Having a C-section Birth
There are a lot of things to consider when developing your birth plan, and a big one is your preferences regarding a Cesarean birth. Since one in three births in the U.S. are via C-section, it’s important to have an understanding of why, the causes, and what you can do to try to minimize your chances of having a surgical birth.
While there are things that you can do to reduce your chances of having a Cesarean birth, it’s important to know that sometimes a C-section is necessary & can save lives. There is no shame in having this procedure and this is a no-judge zone, no matter what your reason (remember: your body, your decision). Having said that, let’s start with an explanation of the reasons why some people have a belly birth.
Medical reasons for planned Cesareans
First, let’s talk about why some new parents plan a Cesarean. There are times when surgical birth is the safer option, and safety is paramount. Here are the top 9 medical reasons for a planned C-section.
Malformed or injured pelvis
Genital herpes
HIV
Baby is in a transverse position (horizontal)
Twins - if the first baby is breech (head up, feet down)
Triplets +
Other birth defects or medical issues with baby or mom
Other reasons for cesareans
Not all Cesareans are planned ahead of time, but they may become necessary during labor. Emergency C-sections can happen fast and be a scary situation, so it’s important to understand some of the events that may trigger the need for an emergency C-section:
Failure to progress (sometimes referred to as ‘failure to wait’)
Sometimes birth can take a while. Your body and your baby are working together to move him / her out of your womb, and the physiological process doesn’t timestamp each step. If your provider is watching the clock or having the ‘time’ chat, it is your right to ask the question, “If there’s no emergency, can I have more time?” And if possible, try changing positions, move around, squat, go for a walk or even shifting to your side can sometimes help the progress. If you’ve had an epidural, try using a peanut ball in various positions with the assistance of your Doula (it looks like a peanut shaped birth ball).
Baby’s heart rate is showing signs of distress
Care providers use tools to monitor and interpret the baby’s heartbeat during labor and birth (aka fetal monitoring). These tools are used by medical staff to determine whether an intervention is suggested (i.e. C-section).
It’s important to note that some research points to evidence of higher Cesarean rates with use of electronic fetal monitoring (EFM) vs. hands-on fetal monitoring. Knowing that, it’s worth discussing with your doctor ahead of time if you want to consider foregoing EFM. The alternative is hands-on with an old school (& quite effective) stethoscope.
Prior Cesarean
This depends on several factors related to your prior Cesarean. The old saying, “Once a C-section, always a C-section,” is no longer true. In fact, 74% of women that plan a vaginal birth after Cesarean (VBAC) will have one (Lamaze). If you had a C-section for your last birth, I recommend exploring your options, starting with the documented reason for your prior Cesarean. (insert link to other blog post here)
Breech presentation
If your baby is head up, feet down inside the womb this is referred to as breech. Although some providers might suggest an immediate C-section, know that breech position ALONE is not always a reason to have surgery. The bigger issue may be that providers are not trained in breech vaginal births. Check out the Heads Up documentary - it’s worth the rental cost.
Also, know that babies can move into an optimal position (head down) while you’re in labor! If you want to get a head start on helping your little one move into a head down position, I’d look into Webster certified chiropractic adjustments, acupuncture, spinning babies and external cephalic version (ECV) - which can be performed by some care providers.
Large baby or big baby
If you’ve been told that your baby ‘appears too big’ or that the ultrasound shows he/she is ‘big’ know this - your baby’s size cannot be accurately determined until they’re in your arms. Size estimates are just that - estimates. If your baby is estimated to be ‘too big,’ often the care providers will schedule an induction or a Cesarean section.
One of the reasons that some providers suggest interventions for ‘estimated’ big babies is to prevent shoulder dystocia (when the baby’s shoulders are too big to pass through the birth canal). This isn’t always necessary, and there is evidence that suggests only 7- 15% of large babies have difficulty with their shoulders. There are also techniques care providers can use for safe deliveries.
Fear
For some, fear and anxiety around labor can be overwhelming, to the point that a C-section is requested. The sad truth is that the media portrays birth in this light, and that’s NOT reality. If you feel anxious leading up to birth, I suggest taking a birth class so that you have a thorough understanding of the birth process, talking to your Doula, working on your mindfulness practices and considering energy healing. Your support system is there for you, even virtually.
Convenience
There is a rise in scheduled Cesareans around holidays and special events because for some, the convenience of scheduling the birth date is preferred. There’s also the ‘I’m in control’ feeling of setting the date yourself. Just remember that scheduling doesn’t take away the risks involved - a C-section is still major abdominal surgery.
What can I do to minimize my chances of having a Cesarean section?
Lots of pregnant moms plan for a vaginal birth, but worry they will end up needing an unexpected C-section. I want to remind you: There is no shame in having a C-section, whether it’s for an emergency reason or if it’s a choice you make for your own reasons.
But in the event you want to avoid surgery, here are 7 things you can do to help reduce the chances of needing a C-section:
Allow labor to begin on its own.
Meaning, avoid medical induction by your provider. Many doctors start talking (read: pressuring for) induction as you get near or past your due date. Fun fact: most women give birth between 38-42 weeks! Remember you are in control of your pregnancy and it’s ok to ask for more time if there isn’t a medical reason for an induction.
2. Check the C-section rates of your provider or birth location.
Ask in your local moms’ Facebook group or International Cesarean Awareness Network (ICAN) group. Choose providers with the lowest rates because it is likely their numbers correlate with their philosophy on labor and delivery practices. Tip: it’s okay to switch providers, even late in the game (I switched at 31.5 weeks with baby #2!).
3. Delay pain management medications.
If you’re considering getting an epidural, let’s make a plan. It’s important to know that a few possible side effects are: slowing down labor and fetal heart rate issues (remember the discussion on monitoring above?). So, what if you delayed getting the epidural? That way your body can progress as much as possible, and possibly reduce some of the side effects? Note that in the absence of medical interventions, such an epidural, your body releases hormones to help you manage contraction pain naturally. Seriously, I felt wine drunk from the labor hormones.
4. Remain mobile.
By switching positions during labor, you can help your labor progress. Move around, go for a walk or even climb stairs. If you’ve already had an epidural and aren’t able to get out of bed, try switching sides with a peanut ball in between your legs.
5. Stay hydrated.
Staying hydrated doesn’t isn’t always the first thing you think about in labor. As you work on your birth plan, make sure that your support people (i.e. partner &/or Doula) remind you to drink water throughout labor.
6. Try to turn a breech baby.
Being told that your baby is in the breech position (head up) can be an unsettling circumstance. But remember, it is possible to birth a breech baby vaginally and there are ways to try to help your baby turn. A few examples: use gravity for an inversion or pelvic tilt, having the doctor use their hands for what’s known as an external cephalic version (ECV), acupuncture or even trying temperature changes or music.
7. Use the BRAIN acronym.
During pregnancy & birth, when situations arise that you need to make a decision (& they will), use this tool. Before making a decision, ask:
Benefits -What are the benefits of this option?
Risks - What are the risks associated with making this decision?
Alternatives - What are my other options? If not here, what are my other options elsewhere?
Intuition - Ask yourself… What does your gut tell you?
Need time -or- Nothing - Can this procedure be delayed? Can I take some time to think about it?
Looking for more?
If you’re looking for a deeper understanding, and more help to minimize your chances of having a Cesarean section, I got you. Be sure to check out Module 4 of my online birth class for first time Moms (or here for the VBAC Prep Course). The Complications & Unexpected module teaches you more about how to handle unexpected C-sections and potential complications during labor.