The number of women in the United States having C-sections has gradually gone up over the past few decades. In 2017, the CDC reported the highest cesarean birth rate yet, at 32 percent of all births.
With more than a quarter of women experiencing cesarean delivery, C-sections can be considered normal and even common. Some women, however, may prefer to give birth vaginally for a number of reasons.
Here at Motherfigure, we don’t believe in any “right” way to give birth. Vaginal births aren’t better than cesareans by any means, or vice versa, and a healthy baby should always be the sole goal.
But for those interested in avoiding a non-medically necessary C-section, let’s dig into some helpful tips for being proactive with your birth plan.
How to avoid a C-section tip #1: Choose your medical provider carefully
When selecting your doctor or midwife, ask about the practice’s C-section rates. When you go into labor, your regular doctor might not be available, at which point another provider at the practice would step in to deliver your baby. Every practice, and every provider, has its own philosophy about birth practices.
If you’re trying to avoid a C-section and your labor ends up being complex, you may want a provider you know has experience using natural methods and won’t jump straight into medical techniques. If you’ve decided to work with a doula, you may want to ask for her advice about doctors and midwives she’s worked with, since many doulas have seen different kinds of births at all kinds of practices.
If you want to avoid a C-section, it’s vital to find a provider with a low cesarean rate and open-minded birth philosophy. If you find that your current doctor doesn’t align with what you have in mind for your birth plan, you’re always allowed to find a new one, even if you’re a few weeks from your due date. Your comfort, well-being, and desires, coupled with the health of the baby, are the most important things. Finding a doctor or midwife who will support that is key.
How to avoid a C-Section tip #2: Consider hiring a doula
Research shows that women who have doulas are 26 percent less likely to need a C-section. Doulas also help manage stress, anxiety, pain, and discomfort before, during, and after birth. They’re sort of like a cheerleader, therapist, educator, masseuse, and trusted friend, all wrapped up into one person, professionally trained to support pregnant women.
It’s difficult to pinpoint why, exactly, the use of a doula reduces cesarean rates. Their physical, informational, and emotional engagement and help has something to do with it. Doulas also act as advocates for laboring women. When fear, pain, or potential pressure from medical staff or family members overwhelms moms in labor, doulas can step in to be a voice of reason, safety, and calmness during otherwise chaotic and stressful circumstances.
They’re trained to give posture and positioning advice for more comfort and to help the baby out, provide evidence-based information, and help women communicate with medical providers to follow the birth plan of their choosing. In short, they’re worth looking into if you’re firmly against a C-section.
How to avoid a C-Section tip #3: Try not to induce unless you need to for medical reasons
Sometimes, the bun just doesn’t want to leave the oven. Your doctor may suggest inducing labor if a baby is showing signs of medical issues, such as poor growth or distress. Mothers with high blood pressure, uncontrolled diabetes, preeclampsia, or certain other medical conditions may need to be induced for the safest birth possible.
But the CDC says 25 percent of all inductions aren’t medically necessary—they’re elective. And some studies show that induction can double the chances of C-section. If your doctor is advocating for induction when there’s no immediate danger or risk to you or the baby, you can, and should, feel confident in standing your ground and declining. (If you have a doula, she’ll help advocate for your position!)
How to avoid a C-Section tip #4: Stay home as long as possible
If you’re having your baby at the hospital, try to avoid getting to the hospital before you’ve reached active labor. Hospitals often recommend coming in when you’ve been having contractions that are five minutes apart and last for at least a minute for longer than an hour.
Often, this is a sign of early labor, especially if it’s your first child. But active labor involves more intensely painful contractions—it may be difficult to talk—and backache or leg discomfort/heaviness. The earlier you go to the hospital, the higher the chances of intervention, including C-section, to speed up the labor process.
You should also try to avoid an epidural, at least while you’re in early labor. Epidurals can sometimes help vaginal birth by eliminating much of the pain, but they can also make it difficult for a baby in an odd position to move into a better one, lower your movement and sensation abilities, or require other interventions, like an IV, catheter, and monitoring. If you have a doula or have taken an independent childbirth class, you may have enough tools and guidance to not need pain medication.
How to avoid a C-section tip #5: Communicate and educate throughout your pregnancy
Make sure you and your partner are on the same page when it comes to your ideas about the birth plan and when a C-section would be mandatory. Having a support system is an important part of this journey.
There are also plenty of books and resources with information about techniques, approaches, and ways to pivot during labor. The Official Lamaze Guide: Giving Birth with Confidence by Judith Lothian and Charlotte Devries is a great starting place.
Women’s bodies are created for growing and delivering babies, and as much as we can plan for the birth we want, things don’t necessarily go our way. But no matter what happens, the primary focus is delivering a healthy baby and feeling positive, well cared for, and assured throughout your delivery.