Did you know that the cesarean section rate in the United States in 1970 was 5.5%? And according to the CDC, the cesarean section rate for 2012 was reported as 32.8%. That’s a pretty dramatic increase in major surgeries, don’t you think?
Let me begin by saying that there is no denying that cesarean sections, when used appropriately, save lives. That is not what I am discussing with you today. As a registered nurse who has worked in Labor and Delivery for the past decade, I am concerned and alarmed by the fact that 1 out of every 3 women who give birth in this country does so via major abdominal surgery.
It is my opinion that many of the surgical births that happen are unnecessary and avoidable. Yes, breech babies happen and many times twins need to be born by cesarean section. And I know that most hospitals nowadays do not allow VBACs (vaginal birth after cesarean.) But there are many healthy women who, with a little bit of knowledge and planning, can greatly reduce their risk for cesarean section.
NOTE: This article was written to educate and to shed light on a topic that is not often discussed. There is a casual attitude that has developed over the years regarding surgical deliveries of babies. My intention is not to frighten nor to make people feel bad about having surgical deliveries. My intention is to report facts about the risks of surgical deliveries and other interventions surrounding our birth culture so we can all make the best and most educated choices for ourselves and our families. . I deeply understand that sometimes there is no other choice. And I am grateful that we have capable surgeons at those times.
The Risks of Cesarean Section Births:
- increased risk of maternal death (3-4 times that of a vaginal birth)
- between 20-40% of women who have cesarean section have postpartum complications (hemorrhage, uterine infections, wound infection, UTIs)
- 5 times more likely to get antibiotics than with vaginal birth
- Increased chances of ectopic pregnancy and difficulty conceiving later on
- greater chance of breech presentation with subsequent pregnancies
- delay of establishing a good milk supply (leading to giving up more easily on breastfeeding)
- less satisfaction with birth experience
- Increased risk of respiratory issues, blood sugar issues, and temperature regulation issues
- Risk of premature delivery as pregnancy dating is not always accurate
- Altered gut flora (research has consistently shown that babies born via cesarean section have altered fecal microbes compared with vaginally born babies. And since over 70% of our immune function comes from the gut, this has a huge impact on the over all immune health of babies.)
- Increased risk for asthma and allergies (due to the fact that cesarean babies have have impaired immune cell function because of suppression of regulatory T cells, which regulate the development and function of the immune system.)
- Increased risk of obesity later in life (one study found that children born by cesarean delivery were 15% more likely to become obese during follow-up than those born by vaginal delivery; those born via cesarean delivery had 64% higher odds of obesity compared with their siblings born via vaginal delivery.)
6 Ways to Avoid a Cesarean Section:
1. Live a healthy lifestyle:
Birth is a complicated process that involved many hormones and muscle groups. Having your body is tip top shape will increase the chances that all will go as it should. Eating a REAL food diet and avoiding processed foods will help your body be at it’s healthiest and will help you avoid issues like obesity, high blood pressure, and diabetes (all which increase your risk for cesarean section.) Read more HERE about getting started on a REAL food diet.
Research shows that sedentary women are 4x as likely to deliver via caesarean section as women who did aerobic exercise during the first or second trimester.
2. Choose your provider wisely:
One of the most revealing questions you can ask your provider is what his or her primary cesarean section rate is. This gives you a good idea of their birth practices and philosophies around birth. Also be sure to ask them what facility they use for deliveries so you can find out what their primary cesarean section rate is as well.
Having someone in your corner who agrees that vaginal birth is the best and safest for mom and baby is important. It has been my experience over the past 10 years that there are varying degrees of agreement on this topic. Some practitioners seem to advocate much more strongly for vaginal birth then others.
3. Educate yourself:
Knowledge is power. Get familiar with the birth process and what to expect. This will reduce anxiety and allow you to enter birth with a much more relaxed state of mind. You and your partner will also be more prepared when decision-making time comes.
Having a good understanding of labor will make it easier not to run to the hospital in early labor. Showing up at the hospital too early will increase the chances that you have some sort of intervention. And interventions will increase the risk that you have a cesarean section.
4. Avoid induction of labor:
Over the past decade, I have witnessed an alarming trend of increasing inductions of labor. Be aware that this seemingly safe practice has been shown in studies to more than double your risk of cesarean section.
It is becoming more and more common for practitioners to induce all women before 41 weeks gestation. Be sure to educate yourself on the research before agreeing to be induced before you are actually post-term. Trying to force things when your cervix is not soft and ready to open can increase your risk for cesarean section.
5. Know the facts about interventions:
The casual attitude around interventions in birth has contributed to the rise in cesarean sections. Be aware that augmentation with pitocin and labor epidurals both have been shown to increase your risk for surgical birth.
Yes, I know that there will be folks to tell me that this is not true, but I speak from experience. Continuous fetal monitoring, early epidurals, confinement to bed, early breaking of bag of water, and pitocin augmentation can all increase your risk for cesarean section.
Women need to move during labor. This is an integral part of bringing baby down. Laying in bed will slow things down, increasing your risk for cesarean section.
Prematurely breaking the bag of water can lead to maternal fevers which can increase your risk for cesarean section.
Labor epidurals can reduce maternal blood pressure and compromise fetal well being. Did you know that epidurals also greatly interfere with the complicated hormonal balance of labor? Epidurals reduce the production of natural oxytocin and keep it from going up in labor. We need that oxytocin to make birth happen. This in itself will increase your risk for cesarean birth.
Pitocin increase the force of labor and makes more interventions more likely. But that’s not all. Let’s take a look at the info provided in the warning from the package insert of pitocin .
Risks to Baby:
- bradycardia (slow hear rate)
- permanent brain damage
- increased jaundice
- risk of seizure
- low apgar scores
- fetal death
Risks for mom:
- Anaphylactic reaction
- maternal hemorrhage
- cardiac arrhythmias
- high blood pressure
- uterine rupture
Any and all of these complication if they happen during labor will increase your risk for surgical birth.
6. Surround yourself with good support:
Having someone who shares your philosophies around birth will help you to avoid cesarean birth. Did you know that having a doula as your support person can reduce your chance of cesarean section by over 40%? Doulas are trained in relaxation techniques, massage, positioning, and birth information. A doula can be your advocate during labor. Doulas are also associated with shorter labors, less need for pain medication, increased breastfeeding rates, and less vacuum-assisted births.
And having good support will enable you to stay home longer when your labor does start. Rushing to the hospital at the first sign of a contraction increases your risk for having interventions. My recommendation would be to labor at home as long as possible in the comfort of your own home.
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I want to end by saying that birth is an amazing experience that we go through only a few times in life. I come from a place of complete respect and awe of the entire process. I do, however, acknowledge that interventions and surgical procedures save lives. And I, in no way, want to be judgmental towards the choices women make in birthing their babies. My hope is only to educate and empower women to have the births that they desire.
I hope that some of you out there find this information useful.
Did I leave anything out? I would love to hear if you have any other suggestions.
Photo credit: depositphotos.com / andresr and shalamov
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