As a follow up to my recent blog about VBACs, I wanted to write a counterpart about c-sections. I think VBACs are awesome and an important option for women to have but they aren’t for everyone, and that’s okay. There are very legitimate reasons for you to choose a repeat, scheduled cesarean.
1). Positioning. Your baby is in a position that makes it difficult or impossible to have a normal birth. There are lots of techniques you can try to get baby into a better position, (check out SpinningBabies!) but they sometimes don't work. Not everyone wants or is comfortable with a home birth and if your baby is breech, or a variation of that, there are no in-hospital options for a purposeful breech birth here in Indianapolis. This might have been the reason for your first c-section as well.
2). Health concerns. If you have high blood pressure, preeclampsia, or uncontrolled diabetes (gestational, Type 1, or Type 2) it may be that a scheduled c-section is in the best interest of both you and your baby. This may require an open conversation with your care provider and even a second opinion if that helps you make a decision. If induction is necessary, it can slightly increase the risks associated with VBAC and depending on the fragility of your health, the combination may truly not be in your or your baby’s best interest.
3). Placenta location or abnormalities. Sometimes, the placenta can be too near the cervix to safely birth your baby normally. Sometimes it can even be covering the cervix. If that’s the case, the placenta would come out before the baby and that’s not okay. In rare cases, the placenta can be imbedded too deeply into the tissue of the uterus and needs special care to be surgically removed. Both of these circumstances require extra monitoring and a surgical, often early, birth. It’s also true that the placenta can be located such that it can make a cesarean difficult as well.
4). Personal history. Sometimes survivors of abuse find birth to be empowering and a healing experience. But other women with similar history find it to be very triggering and a scary time. If you find yourself as part of that second group of women a c-section, where you feel more in control and avoid associating those experiences with your baby may be a really good option.
5). You want one. If scheduling a c-section helps you feel in control of what’s happening to you, makes it easier on your family, or if you just truly don’t want to labor again, that’s okay. This is your baby, your body, your choice and you don’t need to justify those choices to anyone just like the women who choose VBAC.
Our bodies, for the most part, are meant to bring our children into the world, whatever way they come. In addition, there are a myriad of other things to consider here too. If a repeat cesarean is really not your first choice, look around and make sure you have all the facts before your decision. If you do decide, or need, to schedule a cesarean birth, a doula can still be part of and helpful during that experience, offering support before, during (sometimes even in the OR), and after the birth of your baby and postpartum doulas offer support at home for however long you need them during your recovery time. Birth is deeply personal and the birth of your children are days you’ll never forget. Make them positive!
Adina Nelson, CD(DONA)
I am a birth & postpartum doula and chlidbirth educator practicing in North Idaho.
She was there every step of the way for me and my husband...I thank Adina for everything she helped us with. She truly is a special person and we will be forever grateful for her! ~Erin