Making Informed Choices: Cesarean Birth
Most parents-to-be don’t go through pregnancy expecting to have a c-section birth when their baby is born.
In Australia, almost 35% of babies are born via c-section, despite leading international maternity health experts suggesting the ideal c-section rate worldwide should be around 10-15%.
Having a c-section can be challenging and confronting, especially if it’s unexpected. Being aware and informed about c-section birth can empower pregnant women to have a positive experience, whether her birth is planned or unplanned.
What is a c-section birth?
A caesarean or c-section is a surgical procedure that delivers a baby through a cut in the lower abdomen and uterus.
C-sections are considered major abdominal surgery and are performed by an obstetrician, who is a doctor, with specialist qualifications that include surgery.
During a c-section, most women are alert and awake, but under what’s called regional anaesthesia. This is usually an epidural or spinal block, allowing the mother to stay awake during the birth but not feel any pain. A general anaesthetic may be given, but this is reserved for extremely serious situations when time is of the essence.
The actual procedure usually takes between 25 minutes to an hour, from the first incision to being stitched back up.
In most cases, you can meet your baby immediately. Ask your midwife and care team for support in having immediate skin to skin and encouraging early breastfeeding. Your partner can be a part of this early bonding process as well.
Why have a c-section birth?
We know there are risks to both mothers and babies with c-section. Research shows these risks include:
Post surgical infection in uterus or incision site
Severe bleeding during or after birth
Reactions to medications, including anaesthetics
Injury to bowel or bladder, or to baby, during c-section incision
Increased risk of complications in future pregnancies, including another c-section
Breathing problems for babies, needing specialist nursing care.
Some c-sections are planned in advance, called elective c-sections.
When a c-section occurs after labour has begun, it’s generally referred to as unplanned or unscheduled.
However many people tend to use the term ‘emergency’ which isn’t always correct. There is a difference between an emergency and unplanned c-section, mostly in terms of urgency.
An unplanned c-section is when a vaginal birth was planned but for non urgent reasons, it’s safer for your baby to be born via c-section.
An emergency c-section will happen urgently to keep you and your baby safe.
Here are the most common reasons for either an elective or unplanned c-section.
Reasons for an elective c-section
Deciding to have an elective c-section isn’t something to do lightly. In most cases, it’s the safest way for your baby to be born.
Your obstetrician will discuss options with you, so you can make an informed choice.
- Your baby is breech (bottom or feet down). Some care providers are experienced in delivering breech babies vaginally but not all.
Previous c-section and a vaginal birth is not safe or desired
Risk of uterine rupture, usually due to a uterine scar or previous uterine operation
Placenta previa, when the placenta is across the cervix, preventing the baby from being born or potentially causing severe bleeding
Health complications which mean labour and birth could be dangerous for the mother
Sexually transmitted diseases such as active genital herpes or HIV which could be passed onto the baby during vaginal birth
Pregnancy with multiples, particularly triplets or more.
Baby has a major birth defect that could be affected by a vaginal birth.
Some women will choose an elective or planned c-section because they have concerns or fears around vaginal birth. This is a non medical reason and while every woman has a right to birth how she chooses, it’s important to discuss the risks of major surgery for you and your baby before making this decision.
Unplanned c-section reasons
Usually when labour begins on its own, the expectation is the baby is born vaginally. This is the ideal outcome but in certain situations, it becomes more risky to allow labour to continue.
Here are the main reasons for an emergency C-section occurring after labor has already started:
Labour has stalled or isn’t progressing as expected (often this happens after induction of labour, particularly if epidural has been used)
Baby’s heart rate is indicating there’s distress (often a case if mama can’t move due to epidural or is restricted to the bed due to continuous fetal monitoring)
Prolapsed umbilical cord, when the cord slips through the cervix before the baby’s head and compromises your baby’s oxygen supply
The placenta begins to detach from the uterus before the birth and causes severe bleeding and potential complications for your baby
Your baby’s head is too large to fit through your pelvis; this is rare
Previous c-section scar begins to rupture or open.
Can I prevent having a c-section?
Statistically, 3 out of 5 c-sections are planned rather than unplanned in Australia. For women who want to avoid having an unplanned or emergency c-section, there are a number of things to consider.
Age and maternal health are big factors when it comes to c-section. While the age you are isn’t something you can change, being the healthiest version of yourself before conception and during pregnancy is something you can control.
Nurtured Birth’s naturopath can support you to achieve the ideal preconception and pregnancy nutrition and health that’s vital to help you avoid complications that might impact your baby’s health and your birth.
Wellbeing includes both the physical and emotional. Regular body therapy, with Nurtured Birth’s massage and osteopathic treatments, helps to align and attune you to your changing body’s needs. Our yoga and mindfulness workshops attend to the body and mind, bringing a mindful connection to both the inner and outer journey of pregnancy.
This attunement allows you to take the lead in determining your pathway of maternity care. Nurtured Birth offers birth education classes and workshops on choosing care providers who will best support you in avoiding unnecessary interventions, such as labour induction, restricted movement during labour, and epidurals that can lead to an unplanned c-section.
One of the best ways to ensure you are in the best position to avoid having interventions that could lead to a c-section is to seek the support of a birth doula. The presence of a doula during labour has been shown to reduce c-sections by up to 60%.
Nurtured Birth’s doula offers knowledge, emotional and physical support during pregnancy and birth, to support your pathway to motherhood.
To be at your best during preconception, pregnancy and birth, let Nurtured Birth support you in this journey. Please contact us to enquire about how we can nurture you.