Prevent Cesarean Surgery

Certainly cesareans have their place in childbirth, and can be a great blessing to parents and babies in moments of medical need. But the cesarean rate in the United States was 32.9% in 2009, or 1.35 million surgeries. Much of this can be attributed to repeat cesareans, but they aren't necessarily the safest option.

Cesarean section is the most common major surgical procedure performed in the United States. Not only does a cesarean leave a physical scar, but it can leave emotional scars as well.

This video, Prevent Cesarean Surgery, won first prize in a contest sponsored by Birth Matters Virginia. Click on the title; it's about five minutes long and very informative.

You should know that you have options if you have already had a cesarean. Search for a midwife or doctor who supports VBACs (vaginal birth after cesarean), and who has good success rates. I would also suggest reading Understanding the Dangers of Cesarean Birth: Making Informed Decisions by Nicette Jukelevics.

According to www.vbac.com, here are some physical complications associated with cesarean:
*The doctor can cause unintended surgical injury to my internal organs, including my gastrointestinal tract, bladder, and urinary tract.
*I am at higher risk for wound, uterine, pulmonary, and bladder infection. Infection can develop within a couple of days of surgery or up to 6 weeks after the birth. Although all women who have a cesarean should be given antibiotics before the procedure, there is no guarantee that they will be available to me before my cesarean and antibiotic-resistant infections are not uncommon in hospitals.
*I am obese (or I am diabetic) and therefore more susceptible to infection.
*I will lose about twice as much blood and may need a blood transfusion.
*I am more likely to be admitted to intensive care.
*I am more likely to suffer complications from anesthesia.
*I am more likely to be readmitted to the hospital days or weeks after the birth for complications directly related to the cesarean.
*I am more likely to develop a blood clot that can travel to my lungs and cause my death.
*I am more likely to experience significant pain 2 to 6 months after the surgery.
*I am significantly more likely to suffer complications, such as increased hemorrhage and injury to my bladder or intestines, if I have a vaginal hysterectomy in the future.
*I am likely to develop pelvic adhesions (scar tissue) that will cause me abdominal pain later in life and complicate any future abdominal surgery that I may need, including another cesarean section.
*I am more likely to suffer from intestinal or bowel obstruction months or years after the cesarean section.
*I am twice as likely to die from a cesarean as from a vaginal birth.
*If I choose to become pregnant again, I am more likely to have fertility problems.
*With my next pregnancy I am more likely to have problems with the location of the placenta, and more likely to have bleeding problems, a miscarriage, and give birth preterm.
*With my next pregnancy I will be at risk for a placental abruption and a uterine rupture.
*If I give birth in the United States, I am highly likely to have no other option than a repeat operation with my next pregnancy.
*Complications from a cesarean delivery increase progressively with each additional operation.

Below are some risks posed to your baby:

*With a scheduled cesarean section my baby is more likely to be born preterm and to be physiologically and metabolically less mature, and may have difficulties with digestion, dehydration, infection, regulating his/her blood glucose level and body temperature.
*A preterm baby is more likely to have breathing difficulties when breathing on his/her own. Respiratory complications can be serious enough to require admission to a special care nursery. My baby is more likely to be at higher risk for persistent pulmonary hypertension, a potentially life-threatening condition.
*With immature liver function my baby may accumulate high levels of bilirubin (a neural toxin) and become jaundiced.
*If my baby is born preterm, he/she is more likely to have learning and behavior problems at school age.
*Being born only 1 week earlier can make a difference to my baby’s health.
*My baby and I are less likely to have skin-to-skin contact immediately after birth, an important factor for maternal-infant attachment and the initiation of breastfeeding.
*Anesthetic drugs used during surgery cross the placenta and can make it more difficult for a baby to breastfeed.
*With a scheduled cesarean section my baby is more likely to die in the first 4 weeks of life and in the first year of life.

The Complete Book of Pregnancy and Childbirth

Do you want to know what's going on inside that belly of yours, week by week, month by month? Are you looking for a more comprehensive, matter-of-fact book than the popular What to Expect When You're Expecting? Check out The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger.

This book outlines everything, literally everything, you may want to know about pregnancy and childbirth. Its title doesn't lie. Spanning 425 pages and featuring beautiful birth photography, you will be guided through the well-being of you and your baby, how your partner is affected by these life changes, how to be in tune with your laboring body, how to deal with labor pain, the medical control of birth, gentle birth, the first hours of your baby's life, and the weeks that follow.

Writes Kitzinger,

"The book describes the choices available to help you decide how you would like to have your baby, in what setting, and how you wish your baby to be welcomed into the world. I include suggestions on talking with your doctor, how to ask things that worry you and share in the decisions. The book offers a map of the route through pregnancy and labor and out the other side, explaining who does what and why, and what happens when things are not straightforward. I have used some of the words and phrases that you may see written on your medical chart or hear from doctors or midwives, so that you will understand them, but the main focus is on experiential aspects of birth — how it feels.

"Pregnancy and childbirth are normal life processes, not illnesses. You feel the surge of life moving inside you, the ripening of your body heavy with fruit, and then the flood of vitality as labor starts and your uterus contracts in wave after wave, bringing your baby into your arms. It is awe-inspiring and deeply satisfying. At the same time, you grow up a little and learn more about yourself and your partner. I hope this book will help you savor the intense reality of childbearing and enjoy it to the fullest."

The Birth Partner

A woman in labor can receive great strength from those around her, whether it's a spouse, partner, mother, sister, friend or doula. To prepare for that monumental role, refer to The Birth Partner by Penny Simkin.

This book teaches you about pre-labor preparations, phases of labor, relaxation techniques, labor and pushing positions, medications, breastfeeding, and the postpartum process.

I've spoken to a lot of people who have attended births and wanted to be helpful but didn't know what to do. Maybe they didn't understand how labor progresses, how to physically help alleviate back labor, or what type of breathing helps a woman while pushing. Add The Birth Partner to your library and refer to it frequently. It will give you the knowledge you need to know how to help the woman you love while she's in labor and recuperating afterward.

Ina May's Guide to Childbirth

Written by Ina May Gaskin, (the most knowledgeable midwife in the U.S., a woman who revolutionized how women can view birth), this book is a must read for anyone who is having or who may one day have a baby, and by everyone assisting in a birth (midwife, doula, nurse, childbirth educator, supportive family member, or obstetrician).

So here's why I love this book:
1. It explains pregnancy, labor and birth as a natural process, not something to be feared or unnecessarily interferred with.
2. Every woman's body is beautiful.
3. Only about 4% of labors at The Farm where Ina May resides have required interventions (out of more than 2,000 births). How do they have such great success? They don't induce labor. They know how to deliver breach, shoulder dystocia, babies who get stuck during pushing, and VBAC. They know how to move labor along without the use of Pytocin or Cytotec. They know how to position and assist women to best prevent tearing. (68.8% delivered with an intact perineum. I don't know about you, but I don't have any friends or family who didn't have an episiotomy or tear, myself included.)
4. Women should be allowed to move around at will. I didn't like at the hospital being hooked up to an IV and machine, asking permission to go to the bathroom. I also got quite worn out from labor, and it would've been nice to eat and drink at will. You may have heard that hospitals restrict food because "if a woman should need a cesarean section under general anesthesia, she might vomit and inhale some of the food into her lungs while she is unconscious from the anesthesia." General anesthesia is rarely used today for C-sections; instead hospitals use epidural anesthesia. "Women who have epidurals during cesareans do not become nauseous as easily, and even if they do vomit, they are conscious and therefore not in danger of inhaling their stomach contents."

In the U.S. in 2007, 31.8% of births were cesarean. Something is seriously wrong. Of 108 VBACs attempted at The Farm, 106 were successful. I have yet to hear of a hospital with that success rate.

Learning more about birth has opened my eyes to a world I didn't even know existed. I understand that there are circumstances when it is best that a woman or baby take advantage of interventions, but that should be the exception and not the rule. The more we meddle in birth and try to "fix" what nature intends, the more women and babies are putting their health at risk.