April is Cesarean Awareness Month. On the blog, we talk throughout the year about healthy birth practices, which also include the best, research-based ways to avoid cesarean. This month, we'll be sharing new and existing resources on specific things you can do to increase your chance of avoiding a cesarean during birth. Today, we're looking at what the research says you can do during pregnancy to avoid a cesarean.
Choose your birth setting carefully. Last year, Consumer Reports revealed that your biggest risk for c-section may be the hospital you choose. This means that if the hospital you choose has a higher than average cesarean rate (23.9% or lower is the target rate), you have a higher chance of having one. If your hospital's rate is not published, you may have to do some digging, either with the hospital's administration directly or with your local ICAN (International Cesarean Awareness Network) group. If you're choosing birth in a birth center or at home, your chance of having a cesarean is considerably lower.
Get to know your care provider. Who you have caring for you during birth matters. If your OB's cesarean rate is high, you will likely have a greater chance of having a c-section. If your care provider performs frequent inductions -- a practice that's been shown to increase the risk of cesarean when performed before parent and baby are ready -- your overall risk for c-section also could go up. Research shows that being under the care of a certified nurse midwife instead of an obstetrician or physician for your pregnancy (which is not only acceptable, but encouraged for a low-risk pregnancy) can lower your risk of c-section. Be an informed consumer -- you research before buying a new car; be sure to also research when selecting the person and practice who will care for you during pregnancy and birth. Interview your care provider before selecting them. Or, if you're already with a practice, open up a conversation about their rates and practices at your next prenatal appointment.
Learn about birth. The more you know about key practices that support a healthy birth and help you avoid a c-section, the better equipped you will be to advocate for that kind of care in pregnancy and in birth. Reading evidence-based books and websites is a great place to start. Take it one step further by taking a childbirth class from an instructor who is certified and teaches according to best research.
Hire a doula. Having continuous support during labor and birth, like that received from a doula, has been shown through research to be associated with lower rates of cesarean. Of course, that's just one of the many benefits a doula can provide, but it's a pretty big one! Some people assume they won't be able to afford a doula, but that's not always the case. There are many ways to pay for a doula, a wide range of doula fee scales, and some health insurance companies will reimburse for part or all of a doula's fee.
Stay active. You don't have to hit the gym every day during your pregnancy, but staying regularly active with structured exercise has been shown to reduce the need for a c-section. Talk with your care provider about exercise and activities that are appropriate for you, but in general, most exercise routines are safe to continue -- and encouraged -- throughout pregnancy. Consider joining a prenatal fitness class to meet others who are in the same boat -- and for an added boost of accountability.