Monday, April 19, 2010

MY List of Things You Can Do to Avoid a C-Section

I've seen a couple of lists lately about the top 5 things a woman can do to avoid a c-section. While I think these lists are good, they differ from my personal list. I thought I'd take the time to write out my list. I guess I'll keep it to a top 5 as well, so as to not overwhelm anyone.

Education for both husband and wife: Some women are able to advocate for themselves in labor, but most are not. Preparation on the front-end is huge. Dad needs to know what is going on and how he can help. He needs to know what's normal and what's not. He needs to know the questions to ask. Having a doula will help with a lot of this. The doula cannot speak for mom, but dad can. I love The Bradley Method for this reason. Both individuals take responsibility for their role in the birth.

Careful Choosing of a Care Provider: Also huge. All the education and preparation in the world won't matter a bit if you have chosen a care provider and/or hospital who is determined that you need to be rescued from your pregnancy, labor and/or birth. This is the step where, if you ignore the red flags popping up during the education/preparation phase, it will bite you in the end. If you are getting information and statistics about your doctor or hospital that make you second-guess their philosophies, don't ignore them. It's never too late to switch care providers. I've had people change in the middle of labor! Typically, care providers like to see you for the last month of your pregnancy. I changed care providers at 33 weeks with my third pregnancy. A bit nerve-racking, but worth it for a great outcome. You will only give birth to this baby one time. Don't take on the "maybe for the next baby" attitude. Do it this time! Do it for this baby! If you don't know where to start, ask your out-of-hospital educator or doula for referrals.

Keep Moving - Don't Lay Down and Take It: Remaining in a hospital bed is one of the worst things you can do. They can/will strap a monitor on you and "watch" you from the nurses station. Health care at its finest! Laying around for your labor leaves it all up to your baby to make its way out. Baby needs movement. He is moving around, changing position, trying to find the easiest, most comfortable way out. If mom is moving -- walking, sitting on birth ball, pelvic rocking, rotating hips, even standing -- she's using gravity and movement of the pelvis to help her baby descend and get into a good position. Mom will have less vaginal exams (which often lead to Failure to Progress diagnosis), less time on a monitor (which often leads to a false-positive signaling fetal distress), and usually a more comfortable and faster labor. What's good for mom is usually what's best for baby.

Drug-Free Birth: I'm not just talking epidurals here. I'm talking inductions as well. Pitocin is a drug. Prostaglandins (cervical ripeners) are drugs. Baby may react "fine" to induction drugs, and he may not. There's no way to know how your baby will react. So trust in your body to start labor on its own. Don't be induced. Stadol, Nubain, Demerol -- they are all drugs that go to the baby. There will be physical results to the baby when they are born if they received these drugs -- more sleepiness, "laziness" at the breast, depressed breathing. If mom had educated and prepared herself during the pregnancy, she probably skipped this step. It's a tough thing to hear a mom's birth story and realize that her c-section was a direct result of her own actions -- induction, pain-relieving drugs, trusting her doctor, and not educating themselves on the normal process and what to do and what not to do. A woman is 50% more likely to have a c-section if she is induced, and four times as likely to have a c-section if she has an epidural. These are numbers that we simply cannot ignore.

Remain Low-Risk: If you do not take care of yourself and become high-risk, you give up a lot of power. You need to physically prepare your body to give birth by regularly doing pregnancy exercises. You need to eat the required nutrition to grow a healthy baby. A well-balanced diet with plenty of protein will benefit both mom and baby. The old saying "eating for two" does not mean eating for two adults! Be wise and mindful in your life choices. Practice relaxation every day. This will help with all aspects of your life, even after the baby comes. Keep stress out of your life as much as possible. Choose pre-natal tests wisely. There are so many that are done these days. Find out why it's being done and what they expect to do with the results. You can opt NOT to do them. Some may unnecessarily put you in the high-risk category if you test positive.

Of course, I must mention that every now and then I do have couples that do everything right and still have a c-section. I recently had one of these and it broke my heart. This mom worked so hard. I truly do not know what she could have done differently. You can't feel bad about a c-section that comes out of a situation like that. I feel sad for her. She really wanted a natural, unmedicated birth, and was so prepared. ICAN will be an important part of her healing.

My c-section rate of people who take my class is 14%. Some of those were necessary and some were not. Most that were not necessary can be traced back to one of these steps. One other way that can often help prevent a c-section is not rushing off to the hospital the minute your water breaks or you realize you are in labor. The longer you are there, the more excited everyone is to intervene.


Dr. Larry Deutsch said...

Expecting mothers can also use hypnotherapy to help prepare for childbirth. Use hypnosis visualization to remain in control of birth experience and move through contractions smoothly.

Sarah said...

What's the above? An automated advertisement?

Anyway, this is a great post, Donna. Tell it like it is. You are so right. So much of avoiding a c-section has to do with what is done before labor. If only more women were convinced that they do not have to be at the mercy of statistics. I've heard a woman talk about her "chances" of giving birth vaginally. She would not be convinced that she had a great deal to do with those "chances."

Mallory said...

Wonderful! (Can you do a post about "5 things you can do to avoid preeclampsia"? Because everyone I talk to seems to think you can't prevent it, and if you end up with it, then it just sucks to be you!)

I am so glad that I found your blog. I am definitely one of those people that should ban myself from baby showers. Unfortunately, even in gatherings that are NOT baby showers, I end up bringing up birthing topics that make me look like a radical hippie! :D

Katie said...
This comment has been removed by the author.
Genie Elizabeth said...

Can you share your reference for "A woman is 50% more likely to have a c-section if she is induced, and four times as likely to have a c-section if she has an epidural." So that I can share that info with my family and friends.

Also does the later mean that with an epidural your chances are 128% for having a c section (32% x 4)? I want to be able to show them all the correct math and numbers.


Rachel J. said...

That's a great list, I love everything you said. Childbirth preparation for both parents is so critical, because when mom is in labor land she needs to be able to trust that her other half will support and understand what she wants. I know the first comment left was a bit of a spam, but from personal experience, both for myself and as a doula/apprentice midwife with laboring moms, Hypnobabies is another excellent way to prepare both parents.

I also wanted to mention doulas (saw you had it tagged with doula but didn't see it mentioned). They can be a huge asset in providing additional education before the birth, and obviously helping reduce the need/desire for pain meds. If the cost of a doula makes it seem like a frivolous expense, just consider how much out of pocket you'll have to pay to cover an epidural an cesarean. It might be worth paying (probably less) on the front end for a doula and significantly reducing your chances of having the expensive (and uncomfortable, with increased risk) medical interventions.

Donna Ryan said...

Rachel, you are right! A woman birthing in an American hospital must have a doula by her side! I guess I lumped that into the putting the right birth team together. You were paying attention!

Genie, I read those stats about a year or two ago and recently heard them again at the CIMS conference in Feb. by a birth researcher. I am searching for my source. I apologize for taking my sweet time! I will get over this sinus infection eventually - right?

Mallory, I cover that info in class, so that's why I've never put it on the blog. I will do it though. It should be addressed.

Sarah, I got your message about water birth. I will do a post about it. I have a midwife speaking in my class this week who is very into water birth. Maybe after that...

sara said...

The last 3 births of people that I know all ended in c-section. Yet, when I brought up topics like researching epidural use and induction, those same people spouted what their ob/gyns or friends told them "you never know what's going to happen..." I guess we did know, though.
I know I was fortunate, but my birth was 5 hours total and 30 minutes of pushing, mostly in my tub at home. I tolerated no talk of induction from my doctor and didn't stress about the due date, and I trusted that I would be able to give birth normally and without intervention. And I did, and it was great :)