How to Reduce the Risk of Having a C Section?

Cesarean section can be one of the important reasons to have a life-saving delivery, but in some cases, you can avoid cesarean section according to your doctor’s advice. If you have the right conditions according to your doctor’s opinion, it is better to have a natural birth. In this article, we have introduced conditions that will help you have a natural birth.

How to reduce the chance of cesarean delivery?

1. To allow prolonged latent phase (early) labor.
2. Consider cervical dilation of 6 cm (instead of 4 cm) as the beginning of the active phase of labor.
3. Allow more time for labor to progress in the active phase.
4. If a woman has already given birth, she should be allowed to push for at least two hours, and if it is her first delivery, she should continue pushing for 3 hours (in some cases, more).
5. Using auxiliary techniques for natural childbirth (use of forceps)
6. Encouraging the patient not to gain too much weight during pregnancy

Important topics in health care

• Explore pain management options. It is preferable to avoid epidural analgesia at the beginning of labor because it limits the movements of the fetus and the mother.
• Continuous electrical monitoring of the fetus should not be done because it increases the chance of a cesarean by one-third.
• Avoid induction of labor as much as possible.
• Get the help of a specialist like a midwife to support the mother even more.

What are the ways to avoid cesarean section?

1. Choosing the right doctor and hospital: Ask about the number of cesarean sections performed by the doctor (call and practice). A hospital with a positive atmosphere and a supportive team of care providers greatly contributes to the outcome of the birth.
2. Selection of midwives and delivery center: the rate of cesarean section by midwives is lower than that of OBs and they do not quickly average to cesarean section. that the midwife will have all the training, tools, and medicines to keep you and your baby safe.
3. Communicating with the care provider: It is important for the pregnant woman to communicate with her midwife or specialist doctor during the prenatal visits and ask her questions. (write down important questions so you don’t forget)
4. Employing a doula: Studies have shown that a doula reduces the chance of cesarean section by 40%. A doula is trained and experienced in childbirth and provides continuous physical, emotional and informational support to the mother before, during, and after the birth of the child. A natural childbirth doula can help with position changes, massage, decompression, hydrotherapy, aromatherapy, coaching and support during each contraction, and more. Note that doula services may not be covered by health insurance.
5. Allow labor to start spontaneously and avoid induction: Induction should only happen when it is medically necessary for the mother and the baby. Oxytocin (a synthetic form of oxytocin, a hormone that causes labor contractions) is used to induce labor. Therefore, if it is medically necessary, induction is a good option instead of resorting directly to a cesarean section.
6. Work at home: If you feel contractions at home, don’t go to the hospital quickly, because they may return you home due to the number of contractions and the duration, and they will ask you when your water bag breaks or your contractions. It was repeated at an interval of 5 minutes. Go to the hospital. Each contraction lasts for one minute and this continuous pattern is continuous for one hour (Rule 5-1-1).
7. The bag of water should rupture naturally: Artificial rupture of the membranes is not always an effective way to speed up labor and it only makes the contractions more painful and reduces the heart rate of the baby and also increases the possibility of infection. After the rupture of the water sac, the mother should usually deliver the baby within 24 hours to avoid infection and chorioamnionitis.
8. It is better not to perform an epidural early: in the case of an early epidural, Pitocin will not be able to help with childbirth, and the longer you wait for the epidural, the less likely it is to have a cesarean.
9. Intermittent monitoring: If the mother has been induced or has taken medication, she should be monitored continuously to check that the fetus has not reacted to the medication. Monitors must be attached to the baby even when the mother tends to move and walk to register the fetal heart rate.
10. Questions to ask during delivery: If the doctor recommends a cesarean section, ask your doctor if the baby is okay. Or is there any danger at this stage or not? And if the mother and the baby are fine, the mother can request to wait to avoid cesarean delivery.
11. If you have already had a cesarean section, find a medical service provider that supports VBACs: not all doctors allow vaginal delivery after a cesarean section, so if you decide to have a baby after a cesarean section, be sure to check this issue. Discuss with your doctor.

Consider a certified midwife

Before using a midwife, be sure to check her credentials as a nurse-midwife who has a midwifery license. Midwives are not trained to perform surgery or high-risk deliveries, and most of them are affiliated with hospitals or gynecological associations.

Ask the service provider how often he performs episiotomy and if he does it or not. Midwives are not trained to use instruments such as forceps and do not have the privilege to do so (these devices save the lives of the mother and the child).
Midwives cannot prescribe drugs or anesthesia, so their patients generally require less pain medication.
If you have a high-risk delivery (twins, gestational diabetes, high blood pressure, or chronic problems), be sure to seek help from a gynecologist and obstetrician for delivery, not a midwife.

Be sure to consult a gynecologist

Go to a doctor who will respect your decision about the delivery method and give you the right advice. Ask about the number of C-sections your doctor has performed, ideally around 15-20%.

Attend childbirth classes

Participating in these classes will provide you with proper information on breathing techniques, and how to go through childbirth without medication or intervention, and you will learn how to manage your pain naturally through posture and breathing exercises.

Adjust diet and exercise

Eating a healthy diet with plenty of protein, fruits, vegetables, and complex carbohydrates will help you be at your best at the right time.

Note: obesity is the biggest risk factor for normal delivery, which increases the chance of cesarean delivery. Avoid being underweight or overweight during pregnancy.

The mother should have a balanced diet that includes four groups of fruits and vegetables, protein, dairy, and grains. The daily diet should include five servings of fresh or frozen fruit, six ounces or less of protein such as meat, fish, eggs, soy, or tofu, three to four servings of fresh or frozen vegetables, six to eight servings of grains such as bread, rice, pasta, and cereal. Breakfast and two to three servings of dairy products such as yogurt and hard cheeses.

As long as your doctor approves, moderate exercise will help keep you fit and ready to meet the demands of labor. Exercises such as swimming, walking, and yoga are very suitable. Prenatal yoga improves sleep, reduces any stress or anxiety, and gives muscles more strength, flexibility, and endurance for smooth delivery. It can also reduce the risk of preterm labor and other birth-related issues that can lead to an emergency C-section.

Note: Avoid sports that require lying on your back after the first trimester, as well as contact sports and activities that pose a risk of falling, such as skiing, surfing, and horse riding.

During pregnancy, find a suitable position for sleeping, for example, lying on your left side and bending your legs, and using one or more pillows in the lower back can be suitable.

Avoiding unnecessary interventions during childbirth

The first stage of labor has mild contractions that last a long time, and walking, standing on your feet, and squatting during this stage will help labor continue in a healthy and natural way until you reach active labor. It is often medically necessary to induce labor with drugs or instruments. But as long as the mother and the baby are doing well during labor, it is better to avoid labor induction. Instead, you can use the breathing and birthing techniques that are used to encourage labor together with the birthing partner, spouse, or doula.

The increased need for cesarean delivery may be somewhat reduced by waiting until the cervix is ​​at least 5 cm dilated before receiving epidural or other medications.

Turning the breech baby by a gynecologist

A breech baby is a baby whose leg is first placed at the exit of the uterus, and if it does not move, it can cause complications. Turning the baby who is in a breech position so that the baby’s head is placed at the exit of the uterus helps to reduce the chance of cesarean section.

If you want your partner to be in the delivery room, make sure that she knows the type of labor you are having and that she can support you through contractions, remind you of your goals, and when you are too tired to do it. Do it effectively, let it speak for you.