Your baby’s due date is approaching, and you’re probably beginning to feel how real everything is. This is happening. YOU are going to have a baby! If you have started researching birth and watched Youtube videos on vaginal births and C-sections, you may realize having a cesarean delivery is major surgery.8 First, thank goodness for cesarean births because they have saved millions of women’s and babies’ lives.9 However, it isn’t something I would recommend electing to schedule without medical reasons. If it is your first choice to have a C-section, be sure to educate yourself on the procedure and the recovery fully. I want all our readers to be well prepared. And if it’s not your first choice, there are ways to help avoid a C-section or lower your chances of having one.
11 Ways To Help You Avoid a C-Section
If a C-section is something you decide is best for you and your child, I support you! If you’re trying to avoid a C-section as much as possible, there are some things you can do to lower your chances of having one:
1. Choose Your Doctor and Hospital Carefully
Many women think their regular OB-GYN is automatically the person who should deliver their baby. This is not true. I know you probably have an excellent relationship with your doctor; otherwise, you wouldn’t be going to them. However, you need to ask some tough questions to see if they will support you with the birth experience you want. You only get one time to give birth to this baby. And this experience can affect your future pregnancies and births.10,11
Suppose your doctor isn’t giving you the answers you want or is stalling with their answers. In that case, I recommend you consider looking for another doctor because whoever is your medical provider is a significant way to avoid or lower your chances of having a C-section. Here are some ways to go about choosing your doctor/hospital:
Inquire About Your Doctor’s C-Section Rate
Be sure to ask your doctor about their C-section rate so you know how often they perform them. This can give you an idea if a C-section is in your future or if you can avoid it. The national average of cesarean births in 2021 was 32.1% (about one out of three women).1 But some doctors have much higher and lower averages than that.
Look Into the Practice or Call Group’s Rate
You also want to ask what their practice’s/call group’s C-section rate is. Your doctor might not be the person at your birth, which happens a lot of the time. Ensure you understand how the on-call doctors practice, their C-section rate, and their philosophy on birth. Another question to ask is which hospitals they have privileges at.
Ask Others for Recommendations
Start talking to people in the community as well. (I highly recommend asking doulas in your area since they have likely been to the majority, if not all, of the local hospitals.) You will quickly learn which hospitals you want to avoid. Some hospitals have better reputations than others. Having a positive atmosphere and support team of care providers can help tremendously with the outcome of your birth.
2. Or Choose a Midwife and Birth Center
Some people think having a midwife might be weird or even scary, which is unfortunate. A midwife is a safe and fantastic option. Midwives genuinely believe in your body and its ability to give birth.12 Midwives also have a much lower C-section rate than OBs — ranging around 30-40%.2 Unfortunately, some doctors are a lot quicker to recommend a C-section, even when there might be more alternatives you could try. Midwives don’t quickly resort to C-sections as often as doctors, but they will call for one if you truly need it.
If you do not feel comfortable having a home birth, you can choose to give birth at a birth center. Your environment there will be calm and peaceful as well. No matter where you choose, you can feel safe that your midwife will have all the training, tools, and medications to keep you and your baby safe. Talk to your local midwives and visit your local birth centers to learn more about these options.
3. Communicate With Your Care Provider
Whether you decide to move forward with an OB or a midwife as your care provider, you must communicate and ask questions during your prenatal visits. Let them know what your wishes are. The more you communicate and talk about what you want, the sooner you will discover how they will assist you and how your birth may go by hearing their replies. I have seen several OBs and midwives practice very differently from what they led their patients to believe during prenatal visits. I also recommend keeping a list of questions on your phone or a piece of paper so you won’t forget those important questions. Otherwise, pregnancy brain can set in!13
4. Hire a Doula
Studies show that doulas lower the chances of C-sections by 40%.3 A doula is not a midwife. A doula is trained and experienced in childbirth and provides continuous physical, emotional, and informational support to the mother before, during, and right after birth.14 They’re there to help you achieve your desired birth preferences and help you avoid or lower your chances of a C-section.3,15,16
A doula will make suggestions and advocate for you if you are too distracted or delirious to make these decisions. They can help you determine the right time to get an epidural and when and how to change into different positions after you receive it.17 If you want a natural birth, they can help you with position changes, massage, counter pressure, hydrotherapy, aromatherapy, coaching/supporting you through each contraction, and so much more. They will also help keep your partner involved and comfortable.14 And a doula can help you ask the right questions if your OB or midwife suggests a C-section. Hire a doula to help you avoid a C-section!
5. Let Your Labor Start On Its Own
Don’t get induced, if possible. While your doctor may say that an induction will not increase your chances of a C-section, I still recommend avoiding being induced if possible.4 In my opinion, inductions should only happen if they are medically necessary for the mother and baby.18
Most inductions use Pitocin — a synthetic form of oxytocin, the hormone that causes labor contractions.19,20 However, Pitocin causes abnormally strong and painful contractions, which usually leads women to ask for pain relief.7 This can cause a vicious cycle because pain medications typically disrupt the forces of labor, meaning more Pitocin is needed. But unfortunately, there is a limit that a doctor can give. If the uterus is pushed too hard, it will not relax enough between contractions to permit healthy circulation. This can cause fetal distress, and a cesarean would become necessary. This is known as the cascade of interventions, the chain of events that drives the cesarean epidemic.7
So again, if it is medically necessary, an induction is a good option instead of resorting straight to a C-section. But I would suggest not getting induced if it’s not medically necessary.
6. Labor at Home as Long as You Can
Some women start feeling their contractions and immediately get ready to head to the hospital. Depending on how frequent your contractions are and how long they last, the hospital may send you back home. They’ll ask you to come back when your water breaks and/or once your contractions are five minutes apart, each contraction lasts one minute long, and this is a continuous pattern for one hour straight (the 5-1-1 rule).21 So, stay at home until it is time. Most women feel more comfortable at home, where they can eat, drink, move around however they’d like, get in the tub or shower, etc. Once in the hospital, you will not have all these options available.
Also, the longer you are at the hospital, the more medical interventions could be pushed on you. Interventions have the potential to slow down your labor and birth and pave the way for you to have a cesarean. It is shown that the more interventions that you have, the more likely you will have a C-section.7 So, if you stay at home for the majority of your labor, you will lower your chances of having a C-section.
7. Have Your Water Break Naturally
After a few minutes of chatting and doing a cervical exam, I have often seen doctors tell the laboring mother they are going to break her water. This is when the mother should ask why her doctor feels it is necessary to break her water at this time. It might be a good option, but you might want more time.
The doctor may say it will help speed up your labor. However, artificially rupturing our membranes is not always an effective way to speed up labor. It can cause your contractions to be more painful and your baby’s heart rate to plummet because the water no longer protects and surrounds your baby and their umbilical cord. It also increases your chances of infection.5 This is why it’s good to let the baby break the water on their own unless it’s medically necessary.
Something else to consider is that once your water is broken, the typical rule is you must have your baby within 24 hours (sometimes doctors will allow you to go past that) before you have to have a C-section.22 This is because they are trying to avoid infection, specifically chorioamnionitis.6 Once your water is broken, you are on the clock!
8. Don’t Get an Epidural Too Soon
If you decide to get an epidural too soon (before active labor), it has the potential to slow down and potentially stop your labor.23 Your medical providers will then have to counteract the epidural medication with Pitocin, which is the drug they use for inductions. If you get an epidural too soon, even Pitocin sometimes won’t help. I’ve seen it. You want to ensure you have established a good labor pattern of effective contractions and are in active labor before you decide to get an epidural. The longer you wait to get an epidural, the lower your chances of needing a C-section. Here is when you should get an epidural.
9. Ask For Intermittent Monitoring
If you want a drug-free birth, you can request intermittent monitoring. If you will be induced or have an epidural, you must be continuously monitored.23,24 Your medical team needs to see how your baby reacts to the drugs given to you. Many doctors still want their patients continuously monitored, even when women wish to have a drug-free birth. However, continuous monitoring prevents women from moving as much during labor, which, in my opinion, is vital to having a successful unmedicated birth.25 You can move a few feet from the machine, but that’s about it. This means you may be unable to change positions freely, use a bath or shower to help with comfort and control during labor, or walk the halls.
The medical staff can also become fixated on constantly getting a perfect reading from the monitor. Mind you, the baby moves when you move, so monitors need to be moved to be on the baby to pick up its heartbeat. This can be quite often. So, unfortunately, rather than focusing on the laboring woman’s needs, they sometimes shift to concentrate on getting a constant reading of the baby’s heartbeat.
NOTE: Some hospitals have wireless and waterproof monitors. If your doctor demands continuous monitoring, you can still have the option to walk around, move in different positions, and get in the tub with these monitors continuously on you.
As for intermittent monitoring, it is a wonderful option. Your care provider can still check how the baby is responding to labor, and it allows you to labor the way you want. If you want to move around and get in the water, you can! Also, monitors can be uncomfortable on your belly, so being able to take them off or have them use a Doppler instead is much nicer!
10. Ask Questions During Your Labor
If your doctor is recommending a C-section, ask them these questions first to see if you can avoid it:
- Is my baby okay? Is there any danger at this point?
- Am I okay?
- If we are both okay, can we please wait?
If an OB agrees to wait, it shows there is no urgency, just impatience. Sometimes, a doctor may say, “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?” They might be right, but they might be wrong. You can continue trying; in the end, you’ll know you did everything you could.
11. If You Had a C-Section in the Past, Find a Medical Provider and Birth Location That Supports VBACs
Not all doctors or hospitals will take or allow someone to have a VBAC (vaginal birth after cesarean).26 If you want a VBAC, you also want a doctor with a high VBAC success rate. They obviously will have privileges at a hospital that allows VBACs. Be sure to discuss this with your doctor if you decide to have another baby after a cesarean.
When trying to avoid or lower your chances of having a C-section, keep in mind that hospitals are in the business of babies. Hospitals want to get new patients in the beds and have a good turnover. This is a business for them. So, if you’re there and not progressing fast enough to their standards, they’ll likely make suggestions to speed things up, sometimes to benefit their bottom line, not the patient or child. Know that you have options. This is your baby’s birth and your body. Listen to your gut, and do what you think is best for you and your baby.