Learning from the Type of Cesareans

So what can we learn from these breakdowns?

Some planned cesareans are not medically necessary.  If your care provider says you should have a planned cesarean you should do some research.  You have the right  to get second opinions and research your options.   It will either solidify the choice to have a cesarean, or open your eyes to other options. 

Mother’s Choice is an area where obviously you have more control.  If you are choosing a planned cesarean because of fear of birth, I highly suggest hypnosis to help you overcome that fear.  Hypnobabies is a great program that has helped many moms overcome their fear of birth and have gone onto have lovely births. 

Most “emergency” cesareans are not true emergencies.  Parents wonder how can they know if it is truly an emergency situation.   During a birth if a cesarean is suggested, ask if you can have a few minutes to discuss and decide before you make a choice.  If the answer is “NO!” and the room is filling with nurses and doctors, it is an emergency.   Actually in the emergency cesareans I have experienced as a doula, things were happening so fast, they were not even really taking the time to explain what is happening to mom and dad.  I have been the one saying calmly, “It looks like they are preparing you for an emergency cesarean….”  If they give you time, it probably isn’t an emergency. 

Remember true emergencies are rare.  Typically there is time to make choices.  If a cesarean is mentioned to you during your birthing time by your care provider, I would say the most important thing to do is ask questions.  Starting with:  Is mom ok?  Is baby ok?  If the answers are yes, then move onto BRAND

B– What are the benefits?

R – What are the risks?

A – What are the alternatives?

N – What if we do nothing/wait for another hour?

D – Discuss and Decide (If you say, “We’d like to pray on it” the room empties fairly quickly!)

 Typically in the urgently needed cesareans, the answers to these questions would pretty clearly indicate a need for a cesarean.  If mom or baby is not ok, than certainly a cesarean is medically indicated.  But, if they say if is fine to wait another hour, then it is not an emergency or probably even urgent and you most likely could wait many hours (unless there is a change in mom or baby)    Studies have found that patience can help prevent many cesareans. 

You may have noticed many unplanned cesareans are caused by interventions.  As moms you can find out what routine interventions your care provider does.  You can learn about the pros and cons and risks of different interventions.  During your birth you can ask questions about proposed interventions.  Though I have seen first hand, that sometimes they leave risks out when moms ask during birth.  Doing some research before your birth is important.  Taking an Independent Childbirth Class is helpful with this. 

Learning care provider and hospital guidelines, such as restriction on length of pushing, can help you determine if the care provider and hospital are a good match for you.  Even learning their cesarean statistics is very telling.  I live close to 4 local hospitals.  Their cesarean rates vary immensely.  There are 2 that I would NOT recommend to moms, as they have very high rates, so your odds of having a cesarean will be much higher than if you go to either of the other hospitals.  Often because of hospital and doctor policies. 

Avoiding induction is an important key in preventing an unnecessary cesarean.  If your care provider suggests an induction, do your research.  What is your Bishop’s Score?  What is the reasons for wanting to induce?  Is mom ok, is baby ok?  Remember BRAND?  This will work here too.  Mom’s have changed care providers late in pregnancy to avoid unnecessary inductions.  I even know moms who have gone home after an induction wasn’t working.  Leave the hospital and wait longer. 

Failure to wait takes some effort on your part.  Ask the questions!  Buying more time if mom and baby are ok, may be all you need!  There is no hurry if all is well.   Some OBs may get irritated.  Some really just want to do the surgery so they can go home.  Not all are like this, but they are out there.  So know that it is YOUR choice!  Also try different positions, upright positions if you have been laying down.    

Mother’s intuition is very important and should be respected.  Mother’s are very in tune with their body and their baby and if they have a sense about something, they should act on it.  I wish more OBs would respect that.  This should go for a mom wanting a cesarean, or feeling confident about a vaginal birth.  Mom’s seem to know and they need support for their choice. 

Mother’s fatigue is something most doulas are aware of.  We see it coming and try to help prevent it.  I love Hypnobabies scripts as a doula.  If a mom calls me in the middle of the night, so excited because things are “starting”  I tell her to put on a CD and try to sleep.  Sometimes (I know for my birth it did) it helps them rest until morning, so when their birthing time starts in earnest, they still have energy.  So resting is a key.  So is staying fueled with water and food is important too.  Who would run a marathon with no eating or drinking?  Seems silly, doesn’t it?   Knowing hospital routines and doing your research and knowing it is YOUR choice is essential!

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