Abilene Birth and Doula Associates has created this page to empower and educate women on the risk vs. the benefits of a cesarean as opposed to a vaginal delivery. We also give information to you on VBACs (vaginal birth after cesarean), for those of you that have previously given birth via a cesarean. On this page you will find links with further research to help you make an informed decision for your birth.
What is a cesarean section and are all of them necessary?
A cesarean birth or “c-section” is the delivery of the baby through a surgical incision made in the abdominal wall and the lowest part of the uterus. Today, cesarean births are becoming more popular in the U.S. compared to other countries. There is a controversy surrounding this technique of giving birth, and many would say it is being over used. No evidence supports the idea that c-sections are as safe, compared to a vaginal delivery for mother or baby. Actually, quite the opposite. The increase in cesarean births can actually risk the health and well-being of childbearing women and their babies.
In 1983, one in five American women gave birth via c-section. Today one in three or 33% of women have a cesarean for the birth of their child. The World Health Organization recommends no more than a 10-15% cesarean rate. With a million women having c-sections every year, this means that 330,000 to 500,000 of them are unnecessary.
So, what are some reasons for a cesarean?
∙ Pre-eclampsia (hypertensive disorder)
∙ fetal distress
∙ failure to progress in labor (often the result of a failed induction)
∙ malpresentations, such as a shoulder or brow
∙ prolapse of the umbilical cord
∙ multiple pregnancy- more than two babies
∙ fetal abnormality
Cesarean operations are also sometimes suggested for the following conditions, although research supports vaginal births in these cases. The risk from the cesarean has to be weighed against any potential gains for the baby.
∙ previous cesarean section
If it is necessary for you to have a cesarean, you can ask your physician about that option. Here is a family centered cesarean video that offers some options: Family Centered Cesarean
Effects of the cesarean on the mother:
1. A cesarean may be necessary to save the life of a mother or to get the baby born.
2. A lower segment cesarean is less prone to complications later, heals well and the scar becomes invisible. The cesarean operation itself does not preclude a later vaginal birth.
3. The use of an epidural or a spinal anesthetic makes it possible for the mothers to be awake and aware of the birth to see and hear the baby born.
1. A cesarean section doubles the risk of maternal mortality.
2. Since a c-section is abdominal surgery, there is a risk of damage to other internal organs and blood vessels.
3. C-sections carry a risk of infection, which may prolong the hospital stay, interfere with the establishment of breast feeding and delay postoperative recovery.
4. Studies have shown that women have lower fertility rates following cesarean.
5. The mother who has been unable to deliver vaginally may feel very disappointed. She is no less a mother than any woman, however, she may have feelings of failure, anger, loss of her anticipated birth experience and other intense emotions. She will need comfort and support from those around her.
Effects on the baby:
1. A cesarean may be life-saving for the baby.
2. A cesarean may be less traumatic for the baby than a difficult vaginal delivery, especially if the baby’s health is in question.
1. Depending on the reason for the cesarean, the baby may already be at risk and therefore extra treatment and observation may be necessary.
2. The baby may be adversely affected by the anesthetic.
3. The baby may have a delayed suckling response that may interfere with breastfeeding.
4. The baby born after an elective c-section may be premature, and is more likely to have difficulties with breathing because of the absence of the stress hormones produced by the baby during a normal labor.
5. Early separation of the mother and baby may interfere with bonding.
6. The baby is less likely to be breastfed during this period of separation.
The doulas of Abilene Birth and Doula Associates are very supportive of mothers wanting to achieve a VBAC. We want to let you know what your options are on VBACs for this area and which caregivers and hospitals are most supportive of your choices. When you plan on having a VBAC, it is very important to educate yourself on your available options along with weighing the pros and cons for you and your baby depending on your situation and the reason for your previous c-section. However, in achieving your goal for a VBAC, always make sure you have a support group to back you up. For example: spouse, friend, caregiver, doula, hospital, etc.
Since 1995, 35.5% of US women who had previously given birth by cesarean had vaginal births subsequently-almost 6 times the rate of the previous decade, and the number of VBACs in this country keeps climbing, pushed upward by some combination of medical research , consumer desire, and insurance company directives. A mountain of research shows that both babies and their mothers benefit from a subsequent vaginal birth. According to the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics, The American Academy of Family Physicians, and midwives everywhere, babies are healthier, mothers have fewer problems, and both go home from the hospital sooner after vaginal births. ACOG has also stated, "Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans."
Here are 10 healthy tips if you are planning a VBAC…
1. Get good nutrition and exercise.
2. Receive good prenatal care with supportive caregivers.
3. Educate yourself about the safety of a VBAC birth.
4. Be committed to a VBAC; but also plan realistically, in case another c-section is needed.
5. Create a birth plan, which you will discuss prenatally with your doctor/midwife.
6. Be educated about pain coping skills useful during all facets of labor and birth.
7. Avoid routine interventions, unless medically necessary.
8. Get additional, experienced support to assist your primary support person.
9. Stay well hydrated, eat lightly and stay mobile during labor.
10. Establish a belief in your body’s own ability to give birth.
For more info on VBAC’S, please visit any of these links: