Did you know that C-sections are now the most commonly performed surgery in U.S. hospitals? One in three pregnant women today deliver via a cesarean section, many before the 40th week of pregnancy. The C-section rate has been steadily climbing from a low of 20 percent in 1996 to 34 percent today. In Memphis, hospitals report C-section rates at 40 percent.
Of course, many cesareans are medically necessary. But still, C-sections pose significant health risks for mothers and babies. States a 2010 data brief from the National Center for Health Statistics, “Cesarean delivery involves major abdominal surgery, and is associated with higher rates of surgical complications and maternal re-hospitalization, as well as with complications requiring neonatal intensive care unit admission.”
What some women also fail to realize is, once you have a C-section, this will likely become your method of delivery. Vaginal births after a C-section (VBAC) are allowed by some hospitals, but often discouraged by OB-GYNs as too risky.
What’s going on?
Driving this trend is a number of factors: doctors eager to avoid lawsuits, women eager to avoid labor, and both sides liking the convenience of scheduling a baby’s arrival. But is this best for babies — or mothers? Somewhere along the line, labor has gotten a bad rap. The ultimate activity a woman’s body is designed to do, bring new life into the world, is being diminished. It doesn’t have to be. We spoke with doula Mary Beth Best, childbirth educator Cathy Akin, RN, and Brittney Baird, Women's Health Specialist at Methodist Le Bonheur Germantown Hospital, to learn the steps you can take to have the best birth possible.
Now that you're pregnant
• Get in the best health possible. That means lose weight, eat healthy, and get plenty of exercise. Women who go into pregnancy carrying extra weight are at greater risk for hypertension, gestational diabetes, and other medical issues. In addition, give up smoking and alcohol.
• Consider your options for giving birth. Do you want to birth your baby at a hospital or at home? Would you want to use an OB-GYN or work also with a midwife or doula? Do you want to go natural, have some pain management, an epidural? Seek answer to these questions.
• Find an obstetrics physician (OB) who will support your birth plan. Ask questions; does he support natural delivery, and under what circumstances does he or she perform C-sections or inductions.
• Attend childbirth classes. Become informed so you can be your best advocate as you ready your body for delivery. Hospitals offer classes, as do childbirth educators like Sarah Stockwell with BirthMemphis.
• Carry your baby full-term. A full-term infant is one allowed to be in the womb for 40 weeks. Most women do not give birth on their due date; some babies arrive earlier, some later. Regardless, the last two weeks in utero are critical for brain development. Yes, the last trimester can seem unending, but give baby the best start by allowing her to come in her own time.
Once you're at the hospital
Remember that as a patient, you have rights. If your nurse wants to confine you to bed when you’d rather be walking around during early labor, or should other issues arise that make laboring difficult, request a different nurse. A good labor nurse can make a real difference.
Avoid being induced. There are medical reasons for inducing labor: if your baby is no longer thriving in utero, if your water bag has broken (babies must be delivered 24 to 48 hours of that event), or if labor is not progressing. But scheduling an induced labor for the sake of convenience (be it yours or your physician's), works against what your body can do naturally.
Furthermore, the contractions you experience once Pitocin is introduced are often harder to work with.
Consider your pain medication options. Many women think they won’t survive labor without an epidural. But there are options. While epidurals do diminish pain, they also numb your lower torso, making it impossible to work with your contractions. Our bodies are designed to push a baby into this world. Ask your doctor about the range of medications available. Some take the edge off the pain from your contractions but will still allow you to labor effectively. Despite what your friends or mother will tell you, labor pain, while intense, is manageable. The key is learning how to work with your body, breaking the pain/stress cycle, and having a partner who will support you through this miraculous event.