Cesarean Section

One striking example of the overuse of technology in childbirth is delivery by cesarean section. In 1993, 22.8 percent of live births in the United States were by cesarean section. In teaching hospitals, the rate is now closer to 25 percent. In some cities, a white woman with insurance has a 50 percent chance of having a cesarean section. The cesarean rate is this high because there is a movement to offer C-sections as a viable option to normal birth. During my residency, when cesarean rates began to soar, I thought to myself, “How can it be that 25 percent of women are not able to go through a normal physiological event without the aid of anesthesia or major surgery? How could the human race possibly have survived?”

Because cesarean section is so common, many women do not realize that a C-section is major abdominal surgery and carries the same potential risks as all surgeries, including such complications as bleeding and infection. In addition, many women are not offered the option of vaginal birth if they have had a previous C-section. The medical profession has inadvertently helped create this fear of vaginal birth for thousands of women. This has frightened them into choosing C-section even when given the option of vaginal birth. The truth is that many women (between 50–85 percent) can go on to deliver babies normally after a C-section.

How to Decrease Your Risk of Cesarean Section

Though C-Sections are sometimes necessary, there are ways you can decrease your risk.

1. Check out your beliefs and your doctor’s. Do you believe vaginal birth is safe and natural or dangerous and frightening?

2. Find out your doctor’s C-section rate. Hospitals keep statistics, so your doctor should be able to tell you this.

3. Plan on having a normal vaginal birth. Even if you have had a previous C-section, tell your doctor you would like to explore the possibility of a vaginal delivery. Thirty-six percent of all C-sections in the United States are scheduled repeat C-sections with no indication other than prior C-section.

4. Choose your birthplace carefully. Plan to have your baby where you feel safe and supported. Family-centered maternity care centers offer many of the comforts of home with the safety net of a hospital.

5. Make sure you have labor support. Hire a midwife to check on your progress and a doula to mother you. Work with a doctor who is comfortable having these people around.

6. Do not go to the hospital too early. C-sections are often done for “failure to progress” quickly enough through labor. Recent studies suggest that labor may take longer than we think it should and still be completely safe and normal. Hire a midwife who can meet you at home and check on your progress before you get admitted to the hospital. This will allow you to tune in to your baby and your body’s wisdom.

7. Plan to labor without an epidural. Entering labor with the idea that your body will know how to deal with the sensation will allow you to be more receptive and will create optimal uterine functioning. Epidurals can inhibit the release of the neurotransmitter beta endorphin, which normally increases during labor and is responsible for the euphoria some women feel. Nature designed euphoria as the best possible state in which to meet and fall in love with your baby.

8. Trust that your body knows how to give birth. During labor, women have the opportunity to experience their bodies’ wisdom more than any other time and in a dramatic way. Try not to resist labor. Go with it. Move into the positions that feel best. Know that when you feel comfortable, supported and relaxed, your body will automatically know what to do.