Do I Need a Cesarean? ACOG Says Not So Often, Many Are Preventable

You may know that the cesarean rate in the United States is over 1/3 as of 2011, and probably was even higher in 2013. Cesarean surgery, though common, is major surgery and has a number of risks. Many childbirth professionals have been concerned about this for years, and now ACOG (The American College of Obstetricians and Gynecologists) has joined the concern.

This is great news for pregnant moms who may be concerned about the possibility of having a c-section and the longer recovery time, scarring, and greater risk that c-section brings with it. ACOG developed new guidelines for obstetricians in cooperation with the Society for Maternal-Fetal Medicine regarding when cesarean surgery is needed. These guidelines expand what is considered “normal labor” in light of recent evidence so doctors do not feel the need to move to surgery as quickly. The rest of the consensus statement focuses on outlining the risks of cesareans, and exploring what the new recommendations mean for different causes of cesarean surgery.

What This Means for Expectant Couples

Hopefully, most obstetricians will try to begin following these new guidelines right away. This should mean that women are able to relax better in labor and worry less. However, as is the case with all of us, it can be hard to change old habit, so pregnant women and their labor partners may need to take some action as well.

What Can *I* Do to Reduce the Risk of Cesarean?

There are many things you can do to reduce the risk of having or needing a cesarean. The risk can never be eliminated completely, but it can be greatly reduced. Here are a few of the many available suggestions:

  • Talk to your OB or midwife about the new guidelines. Ask what he or she thinks of them. Try to find out whether or not they intend to follow them, and under what circumstances. Also ask about their cesarean rateIf they seem resistant, find another birth attendant. The original obstetric care consensus on reducing primary cesareans can be found here, and Science and Sensibility has a summary of the new ACOG guidelines for reducing c-sections that is easier to understand.
  • Get chiropractic care during pregnancy from a chiropractor trained in prenatal care and the Webster technique. They can help make sure the hips and spine are aligned in ways that not only help you stay more comfortable during pregnancy, but also helps labor go more smoothly, and can help baby move into a better position. This helps reduce the risk of having labor stop, or having baby in a position that does not work for birth. Find a pregnancy chiropractor here.
  • Eat low-glycemic. How you eat influences how baby grows. Eating slower-digesting carbohydrates, less sugar, and plenty of fiber helps even out blood sugar, and can reduce the risk of gestational diabetes and may help baby grow appropriately, instead of too quickly. Some cesareans are scheduled because baby looks “too big.” Here is a brief overview of low-glycemic eating (also called a glycemic index diet), and some information on how to start eating low-glycemic.
  • Only schedule an induction if absolutely necessary. Inductions are much more likely to end in a c-section than labors that start on their own.
  • Hire a doula, or plan to have a labor partner with you who has been trained to help you through labor. Having a trained labor partner accompany you significantly reduces the risk of cesarean.
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