What is a Cesarean Section?

How important is it to avoid a cesarean section?

My recommendation is that women not obsess over avoiding a cesarean delivery. A mother should pick a birth professional she can trust to carefully explain why a cesarean section has become necessary, should the need for one arise, and then go with her recommendation. It is highly unlikely that an experienced doctor will bully a mother into an unnecessary cesarean section. If the whole prenatal care has been conducted in a "my way or the highway" style, the mom should not be in labor under such a person's care; but if she is, she still should go with the recommendation, because she simply does not have the medical knowledge at that point to determine if her baby's life or brain is at risk or not. Some things that lead to a cesarean delivery are outside the mother's control; others can be addressed during pregnancy and labor in hopes of lowering the risk of ending up with a cesarean delivery:

What to Do Before Labor...

  • Eat well. Remember that "eating for two" in pregnancy means quality not quantity. You cannot stay healthy and grow a healthy baby on junk food. Excessive weight gain increases your risk of having a baby too large to fit your pelvis. There are many excellent guidelines on healthy nutrition in pregnancy. Follow them!
  • Stay fit or get fit: If you are out of shape, you are ill prepared for a successful labor. Remember that labor means work—and it is hard work. Get yourself ready for it.
  • Learn as much as you can about what to expect.
  • Line up knowledgeable labor support. The last thing you will want to do in labor is explain to your support people what is going on and what you want them to do. Insist that the people you plan to have with you in labor come to prenatal classes with you, or hire a labor coach or doula.
  • Pick a good birthing professional you can trust. This does not necessarily mean the doctor with the lowest C-section rate as many factors, such as patient mix, can influence a doctor's section rate. Make sure you pick a doctor or midwife who is willing to answer your questions openly and understandably. Should you end up with a cesarean section, it is crucial that you trust your doctor to be doing the right thing.

What to Do During Labor

  • Keep moving as long as you can tolerate it. Walking, taking a hot shower, or rocking in a rocking chair lets gravity help guide the baby down in the birth canal and helps you keep your muscles loose. Laying flat on your back does not.
  • Try to put off getting an epidural as long as possible. It is not clear from several well-conducted studies that epidurals increase your risk of a cesarean section, but they can certainly slow down your labor, especially if given too early.
  • Rest when you can. Labors, especially first labors, can last many hours. You do not want to reach the home stretch when it is finally time to start pushing, totally exhausted. You may be asked to push with every contraction for two or three hours.
  • Keep up your energy. Eat and drink at least in early labor, so you have enough energy to last you through to the end.
  • Use all the help you can get, be that support people to help you breathe through all your contractions or an epidural when the pain gets to be more than you are willing to endure. Remember that you are the Prima Donna of this event -- let them all treat you like one!

Dr. BurkiDr. Regula E. Burki is an OB/GYN and a Fellow of the American College of Obstetricians and Gynecologists (ACOG). Prior to entering private practice she was a Clinical Fellow in Obstetrics and Gynecology at Harvard University and completed a residency in Obstetrics and Gynecology at Massachusetts General Hospital in Boston, where she served as chief resident. She is the current Chair of the Utah section of the American College of Obstetricians and Gynecologists and a diplomat of the American Board of Obstetrics and Gynecology. She maintains a private practice in gynecology in Salt Lake City, Utah. The views Dr. Burki expresses are her personal views and not necessarily those of ACOG.

Copyright © Regula Burki. Permission to republish granted to Pregnancy.org, LLC.