Our conversation recently was on how we can help families avoid a 1st cesarean, but I think we need to take a step back and ask ourselves, why bother? Why should we try to avoid it? What’s the big deal? So many women in Minnesota have had one, it can’t be all that bad, right? So, why should a low-risk woman try to avoid one in the first place?
We know that vaginal birth is not without its own set of risks and complications, foremost of which is perineal trauma that requires stitches.
But cesarean birth is major abdominal surgery and as such it brings with it risks to the mother.
Including: Increased risk of death
Increased risk of infection
More likely to be re-hospitalized
Moms less confident with their babies
Moms less likely to breastfeed
Risks to the baby include:
Depressed immune system
Hormone level issues
Slower neurological adaptation after birth
Compromised gut flora and all the issues we are discovering that are related to normal gastrointestinal
I want to say here that we are very thankful to have cesarean birth available to those who are truly high risk and for the occasion when low risk women need the surgery for truly medical reasons. It has saved many lives and we do not disregard its value in the birth room. But the staggering fact is that 32.2% (that’s roughly 1 in 3) women who walk into a hospital in the U.S. to simply have a baby are discharged having had a cesarean.
So how does a healthy pregnant women lower her risk of a cesarean birth if that’s her desire? One very important factor is where she will give birth. Most of us automatically think hospital. At first blush this doesn’t seem to be a major factor. One hospital may have a cesarean rate for low risk women of 19% and another one in the same city has a rate of 35%, while the World Health Organization says that the cesarean rate should be between 10% overall and that “rates higher than 10% are not associated with reductions in maternal and newborn mortality rates.” (2015 WHO Statement on Caesarean Section Rates)
Finding this out we then wonder, do we have options and where else do women have babies? In the EBB workshop we look at the statistics of cesarean births for different birth settings and we take a look at independent birth center vs. hospital “birth center” to see how where you give birth is as important as our next factor.
Choosing a Provider
So let’s look at the alphabet soup of providers. Ob/Gyn, MFM, FMD, CNM, CPM, CM, DEM, etc. Each of these professionals are trained in a certain area of expertise and each one is vital to the birth community.
The United States and Canada stand out as the only developed nations with far more OB’s than Midwives. With most Obstetricians following the medical model of care vs. the midwifery led model of care, how does this affect birth outcomes in the United States? In other words, as the United States stands out at 48th on the list of maternal mortality rates worldwide, we at EBBMN hope to help expectant parents improve this outcome.
Some of the stats we find can be intimidating. But our goal is to help expectant parents and birth professionals find good information and a good understanding of the pieces making up the puzzle of healthy birth, improving results as well as the whole birth experience for parents and birth workers.
Elaine Switzer, CD(DONA), CLC, Evidence Based Birth Instructor