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Friday, August 15, 2014

The Pregnant Woman’s Guide to Preventing C-Section

We live in a day and age where planned cesarean sections are routine, and are even recommended for all women. However, this is not a desirable procedure for many women today. There has been a push in recent years for a return to the natural methods of childbirth. This is indicated by the growing popularity of midwives, the burgeoning relatively new field of birth and post-partum doulas, as well as an overall general shift towards being healthy and living a natural life.
There are many reasons to prevent a C-section. There are financial reasons, since the cost of a C-section coupled with the hospital stay required afterwards can cost a new mother and father out of pocket in the tens of thousands of dollars, especially if they have a not-so-great health insurance policy. When compared to the cost of a natural birth (which is more in the area of one to two thousand in deductible or out of pocket), there is a big difference.

A natural birth requires a shorter hospital stay, often only a couple of days. A C-section can cause a woman to be in the hospital for a week or more afterward, especially if there were complications to the woman or the newborn. This can create a significant increase in cost, and for some women it can become a real financial burden.

Another reason to prevent a C-section has to do with the possible long term consequences to the mother in future pregnancies. As mentioned in a previous article, improper placental implantation has been positively linked to previous C-section. A Wikipedia entry about cesarean sections (linked to here ) speaks about several complications that are higher with C-sections, and apply to later births. “Women who delivered their first child by Caesarean delivery had increased risks for malpresentation, placenta previa, antepartum hemorrhage, placenta accreta, prolonged labor, uterine rupture, preterm birth, low birth weight, and stillbirth in their second deliveries.” These same risks were echoed by GynoGab (linked to here )

Some of these risks can lead to maternal mortality, especially placenta accreta. In most cases placenta accreta will lead to hemorrhage since the placenta must detach from the uterus and be expelled after the birth. This is a fact of every birth. With placenta accreta, the placenta is essentially tied to the body through the previous C-section scar, so it cannot be expelled. The article states that women who plan to have larger families should not have elective C-sections. An elective C-section is performed for the convenience of the mother and the hospital staff, rather than in an emergency situation where the mother or baby is at risk.

It should also be noted that in Ina May‘s Guide to Childbirth, she states that these placental implantation problems have become an issue in recent years because surgeons have elected to use a single layer stitch when closing the wound in the uterus, whereas in the past the stitching was done in multiple layers. These multiple layers did not lead to such an increased risk of placental mal-implantation. Women who know they are at high risk can discuss the type of stitching they would prefer if they have a C-section with their surgeon to reduce their risk of these problems.

When placenta accreta occurs, the surgeon attending the birth will often have to perform a complete hysterectomy in order to save the mother’s life. This should indicate how serious of a problem this can become. When this happens, the mother can have no more children.
In addition to these types of complications, there is also a three times higher rate of maternal mortality with a C-section in general over having a natural birth. While natural births can sometimes result in death, the rate of death from a C-section is higher than that in a normal birth. Considering that birth is a natural part of life, and that the female body was designed to give birth, this makes sense.

So, how can the pregnant woman prevent a C-section? Possibly one of the best ways to prevent this would be to have a midwife for your prenatal care provider. A midwife is experienced in taking care of many of the problems that would otherwise lead to a C-section. For example, nuchal cord births (where the umbilical cord is wrapped around the neck), breech births, and twins, can often be naturally delivered by an experienced midwife. For this reason, having a midwife with experience is very important.

Another way to help prevent C-section is to hire a birth doula. This person is knowledgeable about childbirth and can help to calm you if you feel that the labor is lasting too long or that there is a problem. She will likely be able to tell you if there is an actual problem, or if there is actually no reason to panic.

Another way to help prevent C-section is to have frequent pre-natal massages. Multiple studies have shown that prenatal massage can help to prevent complications, interventions, prematurity, and other problems. When complications are reduced, so is the rate of C-section since emergency C-sections are performed due to complications. While the reasons massage helps in this way are not understood, it is worthwhile to try prenatal massage while you are pregnant. For more information on prenatal massage, please click here.

Prenatal chiropractic can also help in similar ways, and you can find a chiropractor trained in prenatal care by clicking here. Prenatal yoga has also been shown to have similar benefits. You can do prenatal yoga in a classroom setting, or by purchasing one of the many DVDs available. Prenatal yoga has become very popular in recent years, as many midwives and even OBs have been recommending it. Consequently, it is likely that you can find a yoga studio offering prenatal yoga in your area. Low impact exercise during pregnancy, such as walking, has also been shown to help prevent complications.

If you have a high risk pregnancy, there may be no way for you to prevent having a C-section when the time comes for your child to be born. In such a case, it is better for you to be informed about all of your options. If you have tried all of the above measures, including massage, chiropractic, yoga, etc., and you must have a C-section, you can still ask your obstetrician to stitch your uterus in multiple layers to prevent future implantation problems. That way, you may be able to have a vaginal birth after your C-section, and continue having more children naturally if that is what you choose. However, as with everything, going into this procedure informed will be the best way to have a successful outcome for you and your children.

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