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| The World Health Organization (WHO) has long recognized that the number of mothers having cesarean sections in North America is too high. The WHO states that the cesarean rate for any hospital need not exceed 8-10%. Yet in some hopsitals, the number is twice to four times that amount. Why is the rate so high? In 1970, the cesarean rate was only 5%. In less than ten years, that rate tripled and has continued to rise. Cesarean sections have saved many lives; those of both mothers and babies. Cesarean sections have made it possible for women with conditions such as placenta previa (placentas lying over the cervix) to give birth without great risk to themselves or their babies. Unfortunately, women with the high risk conditions which require cesarean sections make up a very small number of the cesareans done today. The large portion of cesarean sections are being done for failure to progress and repeat cesareans. Why shouldn't I have a Cesarean? A cesarean section is a major abdominal surgery. With any surgery, there are risks. Cesarean sections when compared with vaginal birth, have a number of increased risks for both mother and baby: • Maternal mortality is four times higher. • Increased risk of infection. • Increased risk of hemorrhage. • Negative effect on future fertility. • Longer recovery time. • Reduced breastfeeding success. • Respiratory problems in infants. • Potential for injury of other internal organs. • Anesthesia related complications. What can be done to reduce the chances of requiring a Cesarean section? Expectant families need to think of themselves as consumers of health care. Education and taking responsibility for your birth experience will be very important to improving your chances of having a vaginal birth, whether or not you have had a previous cesarean. Taking the following steps will help you achieve the birth you want: • Educate yourself. The library and internet are loaded with information on VBAC and preventing primary cesareans. • Take consumer-oriented childbirth education. If your childbirth educator has an affiliation to a hosptial, she is required to adhere to certain guidelines when presenting information. This may or may not influence the amount and type of information you get on VBAC and cesarean prevention. It is better to take a class that is not restricted by hospital policy. • Interview caregivers. Make appointments with OB/GYN's, General Practitioners and Midwives. Have a list of questions ready that will help you obtain the information you need to choose the right caregiver for you. If you are not sure what to ask, call your local childbirth education organization and ask for suggestions. • Plan to minimize the use of pain medications and medical interventions during birth. Most medications have a negative impact on labour progress and can lead to a diagnosis of failure to progress. • Hire a Doula. Studies have shown that having a Doula present at your birth reduced the need for cesarean section by 50%. • Take responsibility for your birth experience. Be prepared to make changes if necessary. If you find out the hospital you are giving birth in has a 30% cesarean rate, it would probably not be wise for you to have your baby there if you are hoping to avoid a cesarean or have a VBAC. • Eat well and stay healthy during your pregnancy. You may want to join a prenatal fitness program or attend a yoga class. Treat your body and your baby well. • Believe in your ability to give birth. Do not waste time and energy listening to bad birth stories that focus on endless hours of pain. Remember your body was designed to give birth. Clearly, all of the above encourage you to play an active role in your care. Make decisions based on information from a variety of sources. Every choice you make during your pregnancy is likely to have an impact on your birth. Surround yourself with people that support your ultimate goal and have faith in your ability to give birth. |
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