Decreasing Your Chances Of A Cesarean Birth

There are many things you can do to improve your chances for a vaginal birth:

1. Take good care of yourself (good nutrition, moderate exercise, avoidance of drugs and tobacco) so that you enter labor in the best possible health. Your prepregnant weight and your pregnancy weight gain affect your risk for a cesarean. Therefore, lose extra pounds before becoming pregnant and work with your caregiver to maintain an optimal weight gain during pregnancy.
   
   
2. Prepare a birth plan with your caregiver to help ensure that you both are working together to decrease your chances of having a cesarean.
   
   
3. Avoid labor induction for non-medical reasons, such as, "tired of being pregnant", convenience for yourself or medical staff, fear that the baby is growing too big, or being a few days past your due date.
   
   
4. Find a caregiver whom you trust, who has low cesarean rates, and who encourages you to use self-help techniques in labor.
   
   
5. If your baby remains in a breech presentation, talk with your caregiver about an external version to turn the baby to a head down position.
   
   
6. Take childbirth preparation classes that emphasize the normalcy of birth and encourage your participation in decision-making and the use of self-help methods to relieve pain and promote labor progress.
   
   
7. Wait to be admitted into the hospital until you are in active labor. Learn to differentiate between prelabor and true labor so you feel confident in staying home until active labor.
   
   
8. Plan to rely on medical interventions only when clearly necessary, since these alter the course of normal labor. Such interventions include artificial rupture of membranes, IV fluids, continuous electronic fetal monitoring, Pitocin.
   
   
9. Use labor coping skills to manage pain. If medications for pain relief are used, try to delay or minimize their use. A light and late epidural has less effect on labor progress than one given in early labor.
   
   
10. Plan to be up and about in labor. Change your position and activity about every 30 minutes if labor progress slows. Instead of lying in the labor bed for long periods, try walking, sitting and taking a shower or bath.
    
    
11. If you have had a cesarean in the past, plan and prepare for a vaginal birth the next time rather than a repeat cesarean. Take a childbirth review class that promotes vaginal births after cesareans (VBACs) and assists you with psychological preparation and practical information.
    
    
12. Consider having a doula with you in labor. Experienced doulas, childbirth educators who help during labor, or birth assistants may be available in your area. An extra knowledgeable support person can be of great help to both you and your partner.

There are times when all the above measures have been employed but, even so, it becomes clear that a cesarean is necessary for a safe outcome. You and your partner should know what to expect with a cesarean and what choices are available.

 

© Excerpt from Pregnancy, Childbirth and the Newborn, c. 2001