I had typed up almost an entire post yesterday and the draft is nowhere to be found. :( I blame Blogger! I will attempt to re-do it but I think some of it will be lost forever.
Sometimes cesareans are necessary. Not nearly as often as they occur, but there are a small percentage of cases (different sources say between 6-10%) where cesareans are truly necessary and can be life-saving for the mother and more often, the baby.
"Hard Indications for a Cesarean"
The following indications almost always indicate the need for a cesarean delivery:
- health problems in the mother (severe toxemia, uncontrolled diabetes)
- active genital herpes at the time of delivery
- placenta previa (the placenta completely covers the cervix making vaginal delivery impossible)
- prolapsed cord
- abruption of the placenta
- transverse position of baby (baby lying horizontally across the pelvic outlet)
"Soft Indications for a Cesarean"
The following are indications that mothers given proper support and advice, can often circumvent.
- Failure to progress. Also called uterine dystocia. 1 in 3 babies are being delivered surgically, but does it make sense that over 30% of women's delivery systems have gone wrong? According to Dr. Sears, in most cases, "it's the failure of the obstetrical system to progress, not the mother's." Hospitals and doctors are still continuing practices that began decades ago that are merely continued out of habit rather than based on any actual scientific research or proof. True story...research this issue if you want to know more. In fact, many of the (outdated) practices continued today can be counterproductive- thus one of the reasons for many C-sections.
- CPD- cephalopelvic disproportion. Simply put-the baby's head is too big to pass through the mother's pelvis. Or the mother's pelvis is not large enough for the baby to pass through. This is actually a very rare occurence. In true cases, it usually occurs if the mother has had an accident that has damaged her pelvis or she experienced malnutrition as a child. Diseases such as rickets cause the pelvis to become malformed. God made women's bodies to birth their babies!
- Also- (I love this) did you know that if a woman squats rather than assumes another birthing position, the pelvic outlet opens by 30%? Squatting is an incredible way to widen the pelvis. Birthing on your back is the absolute worst childbirth position. The woman's tailbone actually flexes backward during birth to allow more room for the baby to pass through. However, if she is on her back, the tailbone cannot move anywhere.
- Fetal distress. The Electronic Fetal Monitor (EFM) might suggest- but not prove- that baby may not be getting enough oxygen. Doctors cannot gamble on their being a false alarm, even though the EFM is proven to not always be accurate.
- During labor, the baby's heartrate usually responds to the mother's contractions by slowing slightly during the contraction, but then recovers to its normal baseline rate as soon as the contraction has finished. There are other things that appear on the monitor (flat trace, deceleration, and other traces) that could possibly be an indication of fetal distress. These traces are most likely when the mother is having oxytocic drugs to speed up labor. Turning the rate of the oxytocics down can improve the situation.
- Repeat cesarean births. Research has shown that 70-90% of women who have had a previous surgical birth can safely deliver their next baby vaginally. More on this later.
- Breech presentation. Did you know that a woman can vaginally birth a breech baby? Yep, it's true. Many midwives will do breech births. "That's so dangerous" one might say. It is not necessarily dangerous if the birth attendant has experience with breech births. If your baby is breech and you still want to birth vaginally, it is often possible. But it would be much better to go to a midwife (or doctor) with experience in breech births rather than trusting in a doctor who has never delivered or even seen a breech presentation. That can be dangerous. Also, there are manual ways to turn the baby into a head-down position.
For More Info, check out the following links: To check the rate of cesarean births in your state, visit this link:
http://www.cesareanrates.com/hospital-level-cesarean-rates/
Scientific American Journal Article on Cesareans in the U.S.:
http://blogs.scientificamerican.com/guest-blog/2012/03/28/cesarean-sections-in-the-u-s-the-trouble-with-assembling-evidence-from-data/#comment-4720
http://transform.childbirthconnection.org/2012/04/caesars-ghost/
What every pregnant woman needs to know about cesareans:
http://childbirthconnection.org/article.asp?ck=10164
"Defending ourselves against defensive medicine"
http://www.theunnecesarean.com/blog/2011/1/10/defending-ourselves-against-defensive-medicine.html
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