How to Decrease Your Chances
Because a C-section is major surgery and carries risks, most women wish to avoid having one if possible. It's not always possible to avoid a section, but there are things you can do to reduce your odds.
Age
First of all, you have to realize that your odds of a C-section are simply higher because of your age. According to the March of Dimes, about 40 percent of women over age 35 will have a C-section. While this figure is high, it does not mean that you will need a C-section. If you actively work to avoid one, you may improve your odds. Keep in mind that your physician is also aware of these statistics. While most physicians do not prejudge a woman's ability to give birth solely based on age, some may be less inclined to work with you to avoid a C-section. Talk to your doctor about what you can do to reduce the chances of a C-section, and make clear your desire to avoid one.
Be Educated
Read and educate yourself about pregnancy, labor, birth, and C-sections so that you will understand whatever happens and will be prepared to deal with it. Arming yourself with knowledge is also likely to reduce anxiety and tension, and it may help you relax more during labor, leading to a successful outcome.
Women who have C-sections are less likely to be successful at breastfeeding. This may be in part to discomfort from the incision, making positioning difficult.
Take a childbirth education class. If this is your first child, it is an essential step to take. You will not only learn about pregnancy, labor, and delivery, but also about breathing and relaxation techniques that will help you cope with labor more successfully. If you had a previous C-section and want to try for a VBAC, ask about a VBAC class.
Stay Healthy
Staying healthy during your pregnancy and following your health-care provider's recommendations are key. Eating a healthy, well-balanced diet and exercising will keep your body in good condition and help you prepare for labor. Also, not gaining excessive amounts of weight, or following your diet strictly if you have gestational diabetes, will reduce the risks of having an oversized baby that can't be delivered vaginally.
Stay Home
Once you go into labor, follow your health-care provider's instructions about when to contact him and when to go to the hospital. Remaining at home as long as possible during the first stages of labor can help you remain calm and relaxed and reduce the risk of medical intervention.
Epidurals and Labor Augmentation
Some studies show that epidurals slow down labor. If you are very concerned about this, you may wish to use alternative relaxation techniques during your labor. If your baby is overdue, the risk of the epidural slowing things is outweighed by the benefit of getting the baby delivered before size becomes an issue.
When your baby is born, he will be evaluated using an Apgar score. The baby is observed at one minute and five minutes after birth. Each of the following factors is rated on a scale of zero to two: heart rate, breathing, activity and muscle tone, the grimace response, and skin appearance. Studies have shown that babies of older mothers score just as well on the Apgar test as those of younger mothers.
Having your labor induced or augmented also increases your chances of having a C-section, although this is most likely the result of the way your labor is progressing rather than the fault of the medication. The risk of needing a C-section from an induction increases if the cervix is not ripe. The use of cervical ripening agents reduces this risk. If the induction fails after two days, most patients will opt for a C-section rather than going home to wait for labor to start naturally. The take-home message is that unnecessary inductions (not medically or obstetrically indicated) should be avoided.
Ultrasounds
Medical opinion used to be that doing a late third-trimester ultrasound could help decide if the baby was large and if induction would reduce the risk of a C-section or shoulder dystocia. However, it has been shown that the risk of shoulder dystocia actually increased in women who were induced in these situations, and the risk of C-section also increased. It is now not recommended that nondiabetics have an ultrasound to help make this determination. For diabetic pregnancies, however, it is legitimate to base delivery decisions on ultrasound-estimated fetal weight.
Stay Mobile
Move around during labor. Remaining in bed on your back does not help your body. Standing, walking, squatting, swaying, and other movements may help move your labor along.
