Cesareans

Once upon a time, there was nothing doctors could do to save women with complications during labor. One day, someone invented the cesarean section. Once they figured out anesthesia and keeping the surgical field sterile, it actually saved many lives that otherwise may have been lost. A cesarean was a great leap forward in obstetrics.

Leap ahead to today. With the average cesarean rate in the US at 31% and some areas hitting 50%, 60% or even 70%, every woman should learn about cesarean sections. Instead of being used as a last resort, at least one third of hospital births end in the operating room. Most of us skate through pregnancy ignoring all talk of cesareans, thinking it won't happen to us. Yet 1 in 3 women are walking out of the hospital with a baby and the prospect of recovering from surgery.

Another problem is that many doctors won't do VBACs anymore. A VBAC (vaginal birth after cesarean) used to be the norm back when I was having my first few children. Even then, however only 60% or so achieved their VBAC. We were allowed a "trial of labor." The problem was that women would still get induced, which caused complications with cesarean scars. Women are simply scheduled for a repeat cesarean now. It has been shown that repeat cesareans cause more complications.

Speaking of inductions, many of them fail and end up in the operating room. Inducing for anything other than a medical reason like pre-eclampsia causes many issues for both mom and baby.

As for "choosing" a cesarean... there is one thing that is very important to remember. A CESAREAN IS MAJOR ABDOMINAL SURGERY. It is not a walk in the park. It isn't like taking care of a hangnail. It is major surgery. It also will affect your choices for every subsequent pregnancy and birth. Suddenly you need to worry about your scarred uterus rupturing during your next pregnancy or birth. (This can happen to a uterus that has not be operated on as well.) You need to worry about the placenta implanting over the scar. When this happens, it it called placenta accreta. The placenta does not release easily at the end of the baby's birth.

Studies show that the mortality rate for both women and babies increase due to cesarean section than for vaginal birth. This means that this surgery is being done too frequently... the risks are beginning to outweigh the benefits.

If your care provider starts talking about cesarean, ask them why. What is the reason it is necessary? Get a second opinion. Switch to a homebirth midwife. Do whatever is necessary to find someone who will let you birht the way you want to. If they can't give you a concrete reason beyond a previous cesarean, baby is too big, baby is too small, etcetera, start shopping around. Maybe if women start choosing their prenatal care with their pocketbook, more doctors will be open to letting women birth more naturally in a way that is beneficial to both themselves and their babies.

Both the AMA and ACOG suggests that cesareans should be done when medically necessary. Apparently no one spread the word to the many doctors who feel it is necessary whenever they have plans for the weekend. To give some doctors their due... there are some excellent obstetricians who put their patients first. It is a shame that they are in the minority. They are true shining lights in their field.

Your other option is midwifery. Many midwives do VBACs, too. Just do all you can to avoid that trip to the operating room. It is so easy to be led right through the doors without meaning to get there. It happens every day. It happened to us during the birth of our first child.

Protect your rights to bodily integrity and your baby's right to a peaceful birth. Learn all you can.

International Cesarean Awareness Network (ICAN)