Wednesday, November 21, 2007

Cesarean Avoidance - Tips For Every Woman

Yes you DO want to avoid a cesarean whenever possible. Cesarean is MAJOR surgery. It is not just another way to give birth. Both women and babies are well designed to give birth often never needing intervention of any type.

Cesarean can be a life-saving technique and used well for some serious medical conditions, including but may not be limited to placenta previa, HELLP syndrome, uterine rupture, placental abruption, cord prolapse, some breech presentations, true fetal distress, vasa previa and high order multiples.

Approximately 50-67% or more of all cesarean surgeries performed in the U.S. are likely unnecessary or become "necessary" from iatrogenic influences (non-medical inductions, AROM, pitocin augmentation, epidural or spinal anesthesia, "fetal distress", suspected big baby, lack of mobility, continuous fetal monitoring, pushing positions and/or technique).

Here are some tips to help you avoid a cesarean and have a positive vaginal birth.

  • Get educated: Book to start with - The Thinking Woman's Guide To A Better Birth by Henci Goer, Ina May's Guide to Childbirth by Ina May Gaskin, The Official Lamaze Guide. Giving Birth with Confidence by Lothian and DeVries. Seek out websites that use evidence-based information and normal birth practice information. TURN off the t.v. from the dramatic birthing shows unless you watch with a discerning eye to figure out what could be done differently and why. Seek out local resources such as La Leche League, Birth Network, Birth Circles and/or a local ICAN chapter to learn from other women. Take a childbirth class that is not a good patient preparation class. Take an independent evidence-based class that gives you tried and true techniques along with the communication skills to use your consumer voice. Study and learn about your rights as a pregnant woman, informed consent/refusal and all the usual interventions and medications (induction, augmentation, AROM, epidural, monitoring, etc.).
  • Interview Several Care Providers: You want to find out what the raw data is for inductions, interventions, epidurals, episiotomy, cesareans, VBAC's and so on. It is important to get at the core philosophy of the care provider. Email me at to receive my handout on this.
  • Interview several and hire a Doula: You want a doula who will fit into your philosophy of birth and labor/delivery needs. One size does not fit all.
  • Use normal birth practices: Stay home as long as possible in labor (if having an away from home birth), choose a care provider who supports and believes in you, use a variety of natural coping techniques, opt out of routine induction, opt out of continuous monitoring unless high risk, opt out of routine augmentation, opt out of routine epidural or narcotic use, opt out of routine pushing position, limit vaginal exams, use mobility, TRUST yourself, LISTEN to your body and baby, accept responsibility for your decisions, BE confident that you are designed for this task.

I hope this has given you a jumping point to go out and birth!

Happy Thanksgiving.


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