April 1 is, of course, April Fools' Day. It is also the beginning of Cesarean Awareness Month -- a campaign to make women, families, providers, and the general public aware of the current state of maternity care as it relates to cesarean birth, including the current evidence, prevalence, and the added need for support, care, and sensitivity. So today, though many people all over will be delighting in pranking and joking each other, we vow only to bring you truths about cesarean.
10 Cesarean Truths You Need to Know
TRUTH: 1 in 3 babies in the United States are born by cesarean (33%). The World Health Organization (WHO) recommends a safe rate of cesarean as 10-15%. C-section rates above 10% do not show improved health outcomes for mothers or babies.
TRUTH: If you have a low-risk pregnancy, your biggest risk factor for having a cesarean is your choice of hospital. Choose carefully! Find out your hospital's rate of cesarean.
TRUTH: A 2011 study found that the most common causes for a first cesarean are (by order of frequency) stalled labor, abnormal fetal heart rate tracing, baby's position in labor, birth of multiples (twins, triplets, etc.), and suspected big baby. However, many of these reasons are not evidence based and guidelines for these reasons (as set forth by the American College of Obstetricians and Gynecologists) are not always followed.
TRUTH: Despite the perception that a c-section birth is in a "controlled setting" and therefore safer, cesaren carries significantly more risks than a vaginal birth -- both short term and long term. These include maternal death, maternal surgical complications, infant breathing complications, placenta abnormalities, and amniotic fluid embolism.
TRUTH: About 9 out of 10 women who have had a previous cesarean will have a repeat cesarean, even though VBAC (vaginal birth after cesarean) is a safe and reasonable option for most.
TRUTH: Many hospitals and physicians have instituted a "VBAC ban," which means they will not care for women who plan to have a vaginal birth after cesarean. Find out if your doctor or hospital has a VBAC ban and learn about your options.
TRUTH: It is NOT true that more women are requesting c-sections these days (also known as "maternal request cesarean"). Learn the real reasons behind our high rate of cesarean.
TRUTH: There are valid medical reasons for cesarean. It helps to know these reasons and open the discussion early on with your doctor or midwife to learn your individual risk for having a c-section.
TRUTH: People who have a c-section, whether planned or unplanned and for whatever reason, need increased support during postpartum. This includes physical, hands-on support, as well as possibly increased mental and emotional support.
TRUTH: Not all people who have a cesarean will have negative feelings about their experience. Not all who have a vaginal birth will have positive feelings about their experience. Birth is more than "healthy mom, healthy baby." Emotions after birth can be complicated and mixed -- all emotions are acceptable. Non-judgmental support is essential.