7 Ways to Avoid a C-Section

pregnant momAfter 10 hours of labor, my doctor turned to me and said, “Time for a C-section.” Before I could say “Why?” or even “Huh?” I was carted off and cut up like a roast turkey while I lay there gritting my teeth and wondering: How did this happen?

While cesareans are often necessary to preserve the health of both mom and baby, stories abound of doctors being slash-happy to ward off malpractice suits or even just to get home in time for dinner. To this day, I ask myself if there’s anything I could have done to dodge my C-section, and it turns out there are plenty of ways to at least lower the odds. Here are 7 things moms can try to curb their risk of going under the knife.

Pick a doctor with a low C-section rate. First off, don't be shy: Ask your OB/GYN about their C-section rate. Like a batting average, it will give you a sense of whether a cesarean may be in your future, too. While 33 percent of births nationwide end up C-sections, the frequency for a particular physician can range way above or below that. “For a healthy woman with a single pregnancy past 37 weeks, you'd like to see that rate around 15 percent,” says Robert Atlas, M.D., an OB/GYN at Mercy Medical Center in Rockville Center, New York, who's studied C-section for the past 10 years and acts as “C-section police” at his hospital, making sure the procedure is truly necessary. And since your primary provider may not be on shift the day your baby arrives, “find out the C-section rate of her call group as a whole,” adds Linda Rice, a certified nurse midwife at Harvard Vanguard in Chelmsford, Massachusetts. “Clinicians with higher C-section rates aren't necessarily bad doctors, but are usually just more conservative and will usually be forthcoming about where they lie on that spectrum.” If a doctor hems and haws about his answer, that's a red flag he has something to hide. 

Or choose a midwife instead. Although midwives handle only 8 percent of all births, they boast lower C-section rates across the board compared to those overseen by doctors, hovering around 3 to 4 percent. Why? Midwives don't perform C-sections, although they can call for one if necessary. The difference is they just don't think they're necessary as often as doctors do. This is due to their training, says Bruce Flamm, M.D., an obstetrician at Kaiser Permanente Medical Center in Riverside, California. Midwives are taught to “see labor as physiology,” he explains. “We OBs are trained to see labor as a disaster waiting to happen.” 

Hire a doula. Doulas attend only 1 percent of births, yet studies show their presence lowers the odds of C-section by 40 percent. A doula doesn't deliver the baby; she's just there to ensure the delivery happens the way the mom wants, making suggestions and advocating on her behalf in case the mom is too distracted or delirious to make these decisions herself. “She may put the mother in the best positions for her and the baby and suggest the right questions once an OB would suggest a C-section,” says Stephanie Heintzeler, a doula in New York, New York. 

Don't get induced. “Induction increases the odds of a cesarean to 40 percent,” says Dr. Atlas. “The reason is if the cervix is not ready, you're forcing a process that might not be ready to be forced.” So unless an induction is medically necessary, try to hold off until 41 weeks, one week after your official due date. After that point a baby's health begins to be compromised; by 42 weeks an induction is par for the course since your placenta stops working well enough to keep your baby healthy. 

Labor at home as long as possible. Traditionally hospitals admit women who are at least four centimeters dilated. But new research suggests most women can wait at home until six centimeters -- and that this could lower C-section rates. The reason: As soon as you set foot in a hospital, you could be exposed to a range of medical interventions that could slow down your birth and pave the way toward a cesarean. “Early interventions confuse the body in labor and things don't progress,” says Heintzeler. “The more interventions the mother has -- like an epidural or Pitocin -- the more likely she will have a C-section.” Even just being stuck in a bed hooked up to an IV and fetal monitor can throw a wrench in things. “Being up and not tethered to monitors or IVs is not only more comfortable but can help your body proceed through labor normally,” says Rice. 

Know that the “standard” labor rate is outdated. One of the first lessons OB/GYNs learn in med school is Friedman's Curve, based on a researcher who found that women's “active” labor (past four centimeters) progresses at about one centimeter per hour. Anything slower was deemed “failure to progress” and a prime C-section candidate. The problem? This research dates back to 1955, and a lot has changed since then that makes this benchmark obsolete. For instance, most of Friedman's study subjects were sedated, and younger, and slimmer than women are now -- all of which makes his curve ideal rather than average. Yet many hospitals still use it as their yardstick to determine whether a C-section is merited. Bottom line: Don't let anyone tell you you're not “progressing fast enough.” Also keep in mind that “hospitals are in the business of moving things along,” points out Debi Tracy, a certified childbirth educator in Oceanside, New York. “So if you're sitting there and not progressing, it's very likely they'll make suggestions to speed things up, often to benefit their bottom line, not to the benefit of the child or mom.” 

If your doc recommends a C-section, ask these questions first. “I have three questions I give my clients to ask their OB if a C-section is suggested,” says Heintzeler. “Those questions are: 1) Is my baby okay, is there any danger at this point? 2) Am I okay? 3) Can we please wait? If an OB agrees to wait, it shows there is no urgency, just impatience. Sometimes they will be like, 'Well, we can wait but things will probably look the same in one to two hours, so why not do the C-section right now?' Yet if we wait those one to two hours, most likely a C-section can be avoided, and if not, the mother knows she did everything she could and had enough time. She will feel more in control, that's the key.”

Did you get a C-section and regret it? Why or why not? 

Image via © iStock.com/YouraPechkin



To add a comment, please log in with

Use Your CafeMom Profile

Join CafeMom or Log in to your CafeMom account. CafeMom members can keep track of their comments.

Join CafeMom or Log in to your CafeMom account. CafeMom members can keep track of their comments.

Comment As a Guest

Guest comments are moderated and will not appear immediately.

nonmember avatar anowscara

I see this as a fairly simply analysis of why you would or wouldn't have a c-section and/or induction, with a LOT of "other" considerations missing in the discussion. Labor & delivery can have more issues than just how fast you progress or how dilated you are. I agree the best thing to do is communicate with your doctor and talk about what it is you're looking for *before* you go into labor, so you're on the same page.

Jeana... JeanaJaybird

At my ob's office they will ask you up front if you are open to elective c-section and/or induction. I personally didn't go that route, but I have several friends who did with no regrets.

Snapp... SnappleQueen

What a bunch on nonsense. Here's the real ways to avoid a c-section.

1. Don't get pregnant.

2. Decide you'd rather risk your baby's life than listen to a medical expert. 

3. Don't get pregnant when you're already overweight. Lose weight, first. 

4. Don't use pregnancy as an excuse to become overweight. 

Lucki... Luckicharmz

I'm sorry but number 2. On your list there is quite often a crock of shit. Pardon my French. Medical experts are NOT always acting in your best interest, and often will guilt women in to c-section to get paid more. The more births they have in a year the more $$ they get, and unless you get the right medical professional they only see you as another dollar sign.

if you legitimately need a c-section then no problem, but a lot of women need to stop being sheep and start speaking up and asking questions.

nonmember avatar Natural Momma

SnappleQueen- You sounds very uneducated. Maybe you should take some classes or do some research on pregnancy and childbirth. My medical "expert" suggested I have a c-section at 39 weeks because my baby was going to be 11-12 lbs. I refused, showed up to the hospital dilated to a 10, and had my natural birth to a 9 lb. 1 oz. completely healthy baby. By the way, I'm obese and had healthy uncomplicated pregnancies and births. And I only gained 20-25 lbs each birth. And did you know c-sections are even more dangerous for overweight people. My next baby will be born at home with a properly trained and educated midwife.

Bloom... Bloom4ever

My 4th child was born via csection...the hospital him and 2 of my other kids were born at has a very low overall csection rate...

With my son I was 2wks over due, had been having contractions off and on for at least 10days...I went into the hospital for an induction...after 48hrs of being induced 3 different ways I was no closer to delivering my son then whe I had arrived...he simply was not coming down why? Nobody knows...his heart rate was fine...my blood pressure was low but holding...my doctor consulted 3 other doctors and talked to me, explained the risks, explained the benefits...we, together, decided csection was in my best interest at the time due to the low blood pressure even though baby was fine...2 hours later, in a non-emergency csection, my son was finally born...there was a LOT of fluid and that could've prevented him from coming down like he should have but we will never know...I'm just glad my doctor spoke to me and told me his thoughts on it, shared his concerns etc with me instead of "we are doing a csection"...I'm glad to have my son here and I'd do it again in a heart beat if I needed to...

nonmember avatar Autumn

Natural Momma, I'm envious! I wanted a natural birth so badly, but my midwife had warned me that it might not be possible. Sure enough, I developed preeclampsia and had to have a c-section. It wasn't exactly urgent, because my OB gave me the option of being induced and trying to have a vaginal delivery. However, once he checked me out, it was determined that there was no way my son would be able to fit through. Still, I was given that option, with my OB saying that it would lead to a c-section. I chose to go ahead and do it. I hate I didn't get to do a natural birth, but having a healthy baby was what was most important.

nonmember avatar nurse

Lol @snapplequeen I love your comment! Especially #2. Are you a L&D nurse? You sound like it lol.

grnsm... grnsmomma

Telling people to wait until they are 6cm dilated and longer than they are told to go to the hospital..SMH. First, I don't know anyone who knew how many Cm they were when they went to the hospital. Can't really reach in there and feel yourself and be accurate. Second, don't you tend to progress quicker towards the end? Not everything your doctor tells you is to sabotage you.

I had to be induced with both pregnancies and I went from 0-10cm in 6 hours with my first and 0-7 in 4 hours with my second. I ended up having a c-section with my second and it was very much needed. They probably should have just done it to begin with, as bad of shape as he was in when he was born I will always wonder if he would have survived the delivery.

Tiffany Lynn

I'm sorry but there is NO way you can avoid a c-section. The title of this article makes me mad. I went through almost 30 hours of labor before I medically had to get a c-section and it was because my son's cord was wrapped around his feet and his positioning was not face down. Never once did my son go into distress but there was just no way physically possible to push him out. I did not care how the baby was getting out, the most important thing was that he was healthy!!
What kind of question is that, "did you get a c-section and regret it?" UGH!! It's not like I made the choice to get one, and I sure as hell DO not regret it because it brought my beautiful son to the world happy and healthy!
Every woman is different!

1-10 of 21 comments 123 Last