Avoiding a cesarean birth

No doubt about it, cesarean births do save lives. Sometimes. But not all cesarean births are lifesaving, and for the health of all involved, it’s best to avoid cesarean birth when it isn’t truly necessary. If you’d like to avoid a cesarean birth, there are some things you can do to reduce your odds of getting a vaginal birth and avoiding surgery.

1. Choose your care provider carefully

Care providers differ wildly in their cesarean rate and policies. If you are choosing between a doctor with an 80% cesarean rate and one with a 15% cesarean rate, your chances of a cesarean will be vastly different. This is a pretty extreme example, but the basic concept is the same.

2. Choose your place of birth carefully

Hospitals also have widely varying cesarean rates, and that is something you can look up online. In my free online pregnancy class “Stacking the Deck for a Great Birth” there’s a video showing you how to research the cesarean rate (and other data) about hospitals in your area. Consider birthing at a freestanding birth center or in your own home as well.

3. Don’t go to the hospital too soon

Moving to the hospital before labor is well established can mean that when things slow or pause (as they sometimes can when you move to a new location) there is a chance staff will want to do a cesarean sooner. In fact, the American Congress of OB/GYN changed their definition of early labor in order to try and lower the cesarean rate from these common slowdowns and pauses!

4. Avoid induction

This one has long been advised, and there are lots of studies showing a potential lowering of the cesarean rate with spontaneous labor. One recent study, the ARRIVE trial, seems to contradict that in a small subset of the population, but overall avoiding induction is a good idea.

5. Have good labor support

Whether that’s family, friends, or a professional doula, having dedicated support in addition to your partner has been shown in numerous studies to reduce the cesarean rate.

6. Be active during labor. Especially during pushing.

Movement and upright positions can help your baby move through the pelvis, so get up and dance, walk, sway, squat, etc. For pushing, try side lying, kneeling, or hands and knees.

7. Avoid or delay an epidural

Once you have an epidural, it’s much harder to stay active, and contractions can slow or stop. Avoiding an epidural entirely, or waiting until later in labor to use one, can help you avoid complications that might lead to a cesarean.

8. Try to turn a breech baby

Before opting for surgery, try doing things to help your breech baby turn, like music, warm baths and an ice pack, somersaults in the pool, chiropractic care, or an external version where a doctor can turn your baby.

9. Take a good childbirth class

Find a class that thoroughly educates you. Ask around and look at reviews. A good quality childbirth class can be found in a hospital, or in a birth center, or in rented classrooms. Or online, like the Birth Connected class! Find the style and approach that’s best for you.

10. If you had a cesarean before, find true VBAC support.

There’s a world of difference between a provider who will “let you try to have a trial of labor” and one who will help you avoid a cesarean. You want someone who is enthusiastically on board with your plan, rather than someone who will let you try but warn you that it’s dangerous.

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