Cesarean birth is on the rise, especially in the United States. The United States now has one of the highest rates of cesarean birth than ever before, and one of the highest rates of any other country in the world; But that doesn't mean that our high rate of cesarean birth is necessary. In fact, US maternal and infant death rates are also at a high. Currently, the US has a higher maternal death rate than 29 other industrialized countries.

Knowing all of these facts, women in the United States have every right to want to avoid an unnecessary cesarean. Cesarean birth, when not clearly and medically indicated, has been indicated in some studies to double or even triple the risk of maternal and neonatal morbidity. Morbidity is used to define any significant illness, injury, or a death. Women who undergo cesarean birth face many extra risks during the surgery, immediately postpartum, and even months following surgery. Their babies also face many risks including premature birth, breathing problems, low apgar scores, fetal injury during surgery, and more.

My intention is not to scare you out of seeking medical attention should you be among the small percentage of women who do need a cesarean. I would like to educate all women about how to avoid a cesarean that is unnecessary.

Key Factors in Avoiding an Unnecessary Cesarean:

~ Educate yourself
~ Choose your care provider wisely
~ Choose your birth setting carefully
~ Access to continuous and professional labor support
~ Avoid unnecessary interventions

Educate Yourself About Labor and Birth
Education is key when it comes to avoiding an unnecessary cesarean. Do research, read books, and ask questions. Really dig deep and learn about induction, epidurals, and other common interventions. Take an independent childbirth education class and inform yourself of your choices and options in your area. Start drafting a flexible birth plan during this time.


Choose Your Care Provider Wisely
Not all care providers are created equally. Care providers and even certain medical practices vary widely in their philosophy of birth, cesarean birth, and interventions. If you have been actively educating yourself on the birth process and common birth practices, procedures, and interventions, this will give you a good start on what to look for in a provider and what questions to ask.

Find out what your provider thinks about cesarean births and what their current cesarean rate is. Remember that OBGYN usually have higher cesarean rates because they are trained surgeons. If you have access to one, try meeting with a midwife. If you do not have access to a local midwife, remember that family physicians can attend births as well, and often have much lower rates of cesarean birth. Most will not be as present as a midwife, but they may be more open to a natural birth approach than some OBGYNs.


Choose Your Birth Setting Carefully
Just like providers, certain birth settings will have different rules and regulations, as well as different cesarean rates and practices. Do as much research as you can on each place you are considering giving birth. It may take a little digging, but you can find out the cesarean rate of most hospitals. Find out from providers, patients, and other birth professionals what the environment and practices are like in that facility. Don't forget to check out the option of giving birth at home.


Access to Continuous and Professional Labor Support
Women who utilize continuous and professional labor support persons such as a doula or professinal labor assistant are at about a 26% less risk of having a cesarean section. While some hospitals and facilities offer doula services, you should seek out and hire your own doula or labor assistant if at all possible. You want to make sure that the person who will be working with you during labor is the right person and that you are completely comfortable with them and confident in their ability to help you through labor.


Avoid Unnecessary Interventions
Inductions, epidurals, certain medications and interventions all increase the likelihood of an unnecessary cesarean surgery. Labor induction increases your risk especially. Seek to avoid labor induction, epidural use, electronic fetal monitoring, and other interventions as much as possible. Explore your options for natural labor methods and freedom of movement during labor and select a provider that respects your wishes.


General Health Care
In addition, good nutrition and general daily exercise during pregnancy can lessen your risk or complications during pregnancy and labor, thus reducing your need for certain medications and interventions that may lead to a cesarean.