1. Educate yourself
The most effective way to empower yourself to make informed decisions about birth, is knowledge. When you understand the terminology of medical birth and the pro’s and con’s of procedures and interventions, you are much less likely to be bamboozled or pressured into something for no good medical reason. The fact that you are reading this means you are already active in educating yourself.
Other forms of education beyond reading are, birthing classes (preferably not run by the hospital where you will deliver). Another is other women. Talk to friends, family, colleagues about their birth experience and get a broad range of other women’s different birth stories. If nothing else you will learn that no two births are alike!
2. Carefully choose your care-provider.
The first step in reducing your chances of an unwanted c-section is who you choose to deliver your baby. It is really important to make this choice with care an consideration. The most important question to ask your midwife, doctor, hospital, is their rates for c-section delivery with low risk mothers. You should be looking for a minimum of 15% or lower. This one piece of information should be a significant guide in your choice of caregiver, additional questions areÂ if they have a set time limit for labor and second stage pushing. And always remember it’s your birth.
3. Hire a doula or have a dedicated labor support person.
Studies have now proven that having dedicated support during labor significantly reduces the chances of a c-section and other medical interventions like vacuum extraction and forceps. At a minimum create a clear birth plan that your partner, doctor and all those immediately involved in the birth have seen and discussed with you, that includes your wishes regarding many of the things below.
4. Stay home to deliver, or until the late stages of labor.
For low risk pregnancies, home birth is a safe an viable option with many advantages over hospital birth. If you are delivering in a hospital there’s no reason to be there until contractions are about 3-5 minutes apart and have been for an hour. This is the active stage of labor. In low risk pregnancies this is a great way to avoid medical interventions and let your labor follow it’s own process and not a hospitals timeline for delivery. Doing this is much easier if you follow #2.
5. Eat, drink and sleep during a long labor.
Many labour units have adopted a policy of no eating and drinking during labor, which makes sense in a pre surgery situation, but in childbirth increases the likelihood of arrest disorders that frequently result in escalating interventions and c-section. It is also important to rest or even sleep as much as possible in the early stages of labor. The length of labor is unpredictable and loss of a nights sleep as labor progresses is not uncommon.
6. Avoid labor induction for no medical reason.
A study published during the summer 2010 found that nearly 50% of women who’s labor was induced or ‘augmented’ with the drug pitocin (oxytocin) end up delivering on the operating table. This thenÂ is another significant talking point with your doctor – ask what their attitude towards labor induction is and ask for their statistics in using pitocin. You can include strategies to avoid induction in your birth plan after research and discussing them with your care giver.
7. Avoid an early epidural.
This is not a statement for or against epidurals. It can be a useful aid in the birthing process and it’s premature use can negatively impact delivery outcomes. Generally speaking once you have had an epidural you will be bed bound. This is because a) it is standard hospital policy and b) depending on the dosage you will have reduced or no muscle strength in the lower body.
Being bed bound you lose the possibility of remaining active in the labor and finding bodily positions that help facilitate the babies descent and delivery. This loss of the ability to move and be active engaged can prolong the labor, increasing the chances of additional interventions such as forceps, vacuum extraction and c-section. After a very long labor, when mom is utterly exhausted, and epidural may provide the pain relief a mom needs and help her deliver vaginally.
8. Ask for intermittent monitoring instead of continuous monitoring:
ACOG (American Congress of Obstetricians and Gynecologists) discourages the use of routine continuous monitoring for low risk pregnancies because it prevents women from moving around in labor (which helps labor progress). Medical research has shown that continuous electronic fetal monitoring can increase the chances of c-section while it provides no improvement in outcome for the baby.
9. Learn pain management techniques.
Childbirth can be the most intense physical experience of a woman’s life and there are biological reasons why that we won’t be covering here. Movies and tv have provided many images of this intensity and for some first time moms there can be anxiety about this. Like all aspects of childbirth, being prepared and having resources to manage the intensity, not only help you to do so but also enhance your empowerment.
Some of the points above like #1, #3 & #5 are particularly relevant to pain management. Some examples are:
Positioning: sometimes a change of position can make a big difference, use positions that utilize gravity.
Breathing: there are many advocates for breathing techniques to assist during labor, practice before hand with the person who will accompany during labor.
Massage: the right touch in the right place can make all the difference in the world, in particular having someone you trust who knows how to give perineal massage.
Water: showers, baths jakuzzi’s, birthing pools can all be helpful at different times. Even if you aren’t entertaining the possibility of a water birth, water can be your friend.
Other options include, vocalizing, visualization, and relaxation techniques. All of these should be taught in a good childbirth education class and practiced as much as possible.
10, Address childbirth anxiety
As mentioned above many of us have subconscious fears about childbirth from tv and movies, sometimes from a film of childbirth when we were in school. If this is the case acknowledging the fears and working through them well in advance will be hugely beneficial. For each woman what this looks like will differ. For some educating themselves about childbirth from many perspectives is enough, for others hypnotherapy has been enormously helpful. In every case, dealing with such anxiety and fear before labor is only going to make things better.
11. Breech doesn’t have to mean c-section
A breech baby does not mean an automatic cesarean. If your baby is breech, ask your care provider about exercises to turn the baby, and if they discount the idea find someone who won’t. There are many techniques you can try on your own or receive from acupuncturist or chiropractor (Webster’s breech technique) If all else fails vaginal breech delivery is possible.
12. Previous c-section doesn’t make it your only future option.
It seems as if the tide of once a c-section always a c-section has turned and vaginal birth after cesarean (VBAC) is once more seen as a safe and viable option for women who have previously had a c-section, It is definitely worth knowing your options for VBAC. The current statistics show that vaginal birth after cesarean attempts have up to an 80% chance of success.
Having said that, there are still many doctors and hospitals who refuse women the option of a VBAC, so if you go this route you will have to find an obgyn who offers vaginal birth after cesarean.