The C-Section: Making an informed decision

 

I’m so, SO excited for my first post in a blog series on birth!  I LOVE babies and I love talking about birth.

I was extremely nervous and scared for my first two births but since then I have learned and experienced so much that it is now my favorite part of pregnancy…and not simply because I get to meet my sweet baby! (and sleep on my back and stomach, and go longer than 30 seconds without peeing, and fit into tight spaces… you catch my drift)

c-section decision

I’m grateful that my birth experiences have been extremely varied.  Because of that, I am very empathetic to all mothers and their births, both those that go as planned and those that don’t.  My first baby was delivered by emergency c-section after Liam’s heart rate kept dipping dangerously low.  I fought like crazy to get a vaginal birth the second time around and I succeeded; Toby was a VBAC (vaginal birth after cesarean) in the hospital, induced with Pitocin and I was given an epidural.  Juliet and Finn, my 3rd and 6th births, were water births at home, and 4th & 5th births, the twins, were natural and vaginal in the hospital (and also my biggest triumphs!).

The thought to write a series on birth popped into my head one day but I wasn’t sure what direction it would take.  Then the idea to write specifically about c-sections literally woke me up one night.  I couldn’t get back to sleep, thinking about all the women who face this decision and how scary it can be.

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This photo is of my little sister in the throes of labor with her first baby.  This was taken at a birth center but she ended up transferring to a hospital and delivering by cesarean.

No one can tell you what birth is best for you and your baby…or what unanticipated twist might occur to change your best laid plans.  But it IS important to plan.  If you read and research and become as informed as possible, then, if life does throw some crazy curve ball at you (twins anyone??), you will be prepared to change plans with minimal stress and still end up with an amazing and beautiful birth!

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This priceless photo was taken just seconds after I caught my 6th baby, Finn, who was born at home, in the water.

The reason I named this blog series “Making an Informed Decision” is because YOU get to decide how to birth your baby.  Yes, even if it ends in a cesarean.  Be very wary of any medical provider who tries to make every decision for you.  In some situations you will weigh the information given to you and it will be very clear that a c-section is the best choice.  In other situations, perhaps not.  But don’t forget that YOU have the last say!

Another important thing to understand about c-sections is that they are not a normal birth outcome.  A cesarean section is major abdominal surgery and has major ramifications for both baby and mother (both in the present and future).  In other words, it is not a decision to be taken lightly.  That being said, let’s all recognize what a miracle these life-saving surgeries are! Millions of women and babies would have very different, possibly catastrophic, birth outcomes without this amazing intervention.  C-sections have saved the lives of many babies and mothers.

Interestingly, the rate of c-sections has been on the rise for the past decade.  It’s currently close to 30% in the US (and 40% in the Arizona county where I live).  While there are lots of arguments regarding an “ideal” rate of c-section, it is widely believed that this surgery is often done unnecessarily.  See some great sources at the end of this post if you’d like to read more.  A cesarean can result in some scary stuff: placenta accreta, infection, blood loss or uterine rupture.  In short, it’s not a procedure you want to elect for if there’s a way around it!

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All the twin pictures in this post are of Vivian and Kira.  I love these shots so much!  Our girls were born vaginally but most of the doctors I interviewed preferred to deliver multiples surgically.

So the question is, why so many c-sections?

There are definitely some clear-cut medical reasons to get that baby out fast.  Some of these include eclampsia (dangerously high blood pressure in mom), problems with the placenta, and other serious medical conditions.

But there are also situations where the decision is less clear and it’s up to both the mother’s discretion and doctor’s opinion.  Some of these include a baby deemed larger than average, a breech or other poorly positioned baby, and previous c-sections*.

In these situations. it’s crucial to be informed and aware of your options.  Below are some great questions to ask your doctor if you’re facing either a planned or emergency cesarean (CS).

Why do I need a CS?
What are the risks of getting a CS?
What are the risks of delivering vaginally?
What happens if we wait and see (i.e. attempt a vaginal birth first)?

By the way, these questions are also a good thing to remember when facing any intervention (induction, epidural, episiotomy, etc).  A “cascade of interventions” is often blamed for leading to an emergency cesarean (i.e. too much “stuff” done to mom and baby).  Experts also blame changes in medical malpractice insurance and hospital policies for the rising rate of these surgeries.

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My last piece of advice is this: don’t be afraid to get a second opinion!  If your doc is telling you something that just doesn’t sit well with you, see another OB or midwife for his/her opinion.  For some reason we often hesitate to second-guess our doctors, but getting another opinion just means you want the very best for yourself and baby.  There are a lot of forces at play in America’s maternity system and sadly, not all providers make decisions that are in the mother’s best interest.  YOU are your own best advocate.

When we trust our bodies and our babies and assume they will do their jobs just fine on their own, chances are good that they will!  If for some reason something goes wrong, be educated enough to ask the right questions and have a birth advocate help you (if you’ve never considered a doula, look into it!  They can be wonderful).  Lastly, if a c-section is necessary, we can be grateful that we live in a country that offers access to this life-saving surgery.

Birth is an amazing, miraculous, spiritual journey and I hope you enjoy it!!

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*I am a huge advocate of VBACs, and I’ve fought tooth and nail for every one of mine (5!).  If you’ve already had one or more c-sections and are interested in learning more about having a vaginal birth, check out ICAN online or email me! I’d love to share what I’ve learned.

Sources:
International Cesarean Awareness Network
Brazil isn’t the only country with high c-section rates
Why is the US c-section rate so high?
C-section by choice

You can find all my posts in the series on birth HERE!

Note, this post is not meant as a substitute for medical advice.  Please consult with a qualified midwife or obstetrician in regards to your prenatal and birth care.

 

Comments

  1. Thank you for this! I totally felt like a loser when I had my C-section but I have come to realize that in my particular case, a C-section was necessary for me and Graham. Here’s hoping for a VBAC for baby #2!

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  1. […] can read the first post in the birth series HERE, written about c-sections and chock full of information that any expectant mother should know, not […]

  2. […] back with another post in my series on birth!  I’ve previously written about epidurals and c-sections and today, we’re talking about […]

  3. […] back with another post in my series on birth!  I’ve previously written about epidurals and c-sections and today, we’re talking about […]

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