How To Reduce Your Odds Of Having A C-Section and how to do a c-section

Take Care of Yourself
Maintaining good nutrition and exercise habits can go far towards keeping you from a cesarean. When your body is healthy, it's more likely to be able to labor successfully. Staying healthy also helps lower your anxiety, which can be a major contributor towards a c-section.

Make sure you practice your Kegel exercises during pregnancy. These will strengthen the muscles that need to work the hardest during labor. When these muscles are strong, you have a better chance of avoiding a c-section.

 

Know Where You Stand
The key to not having a c-section is to do your research. That way, you'll know if the c-section your doctor is proposing is truly medically necessary. This means knowing all about fetal heart rate decelerations (one of the most common causes for emergency cesareans) and other things that can go wrong in labor.

 

It may be scary to learn about these things, but remember that you're just gathering information. If you get into a situation where a doctor wants to do a c-section, it's important for you to know when they are medically necessary and when they are not.

 

Choose Your Doctor Carefully
Some physicians are more likely to do cesareans than others. Talk to yours, and ask specifically what percentage of the births they attend have ended up being cesareans. If it's higher than 15-20%, consider finding another doctor.

 

Note that it may be difficult to change physicians because of your insurance coverage. If this is the case, you may have to work with a doctor who is more "pro-cesarean" than you would like him to be. If this is you, don't despair! It's still possible for you to have a vaginal birth.

 

Avoid Interventions
The more interventions you have during your labor, the more likely you are to have a c-section. This doesn't mean that you shouldn't do something if it will help you or your baby survive or thrive, but it does mean choosing to say "No" when a medical provider suggests something you don't think is necessary or helpful.

 

In general, you'll have a better chance at a vaginal birth if you avoid being induced, and labor at home as long as you can. Also avoid an epidural, constant monitoring, remaining stationary during labor, and delivery with forceps or a vacuum.

 

Draw Your Line in the Sand
Well before you're in labor, decide when you're willing to have a c-section. Based on your research, decide what scenarios qualify as emergencies to you and keep them in mind when you're in labor. If you are comfortable doing so, let your doctor know about these situations ahead of time so he or she has a heads up before labor begins.

 

Note that you never HAVE to have a c-section. You can always refuse. While they may require you to sign something saying that you refuse it against the advice of a doctor, they cannot make you have surgery.

 

Be Prepared to Make Your Case
Prepare yourself to stand firm. It can help to actually rehearse in your head what you want to say to a doctor who proposes surgical delivery. If you've said it before, even if just to yourself, it will be easier to say it when the time comes.

 

In addition, let anyone else who is going to be in the delivery room know what you want to say and when you want to say it. Enlist their help in holding your ground. You may even want to hire a doula, who will specifically be your advocate with the medical staff.

 

Ask Questions Before You Agree to Surgery
When you're in labor and a doctor proposes a c-section, you can always ask questions. One key one is, "Am I or my baby in danger of sustaining lasting damage if I don't have a cesarean in the next 10 minutes?" If the answer is yes, you'll know it's an emergency. If they say no or avoid answering you directly, you'll know that you have a little bit of time.

 

It can also help to ask for a little more time. If the danger isn't immediate, tell the doctor that you want to be reassessed in 10 minutes, 20 minutes, or even 30 minutes. That way, you'll be able to see if the problem is going away, or if it's something that needs to be dealt with surgically.

 

Once the anesthesia has taken effect, your belly will be swabbed with an antiseptic, and the doctor will most likely make a small, horizontal incision in the skin above your pubic bone (sometimes called a "bikini cut").

 

The doctor will cut through the underlying tissue, slowly working her way down to your uterus. When she reaches your abdominal muscles, she'll separate them (usually manually rather than cutting through them) and spread them to expose what's underneath.

 

When the doctor reaches your uterus, she'll probably make a horizontal cut in the lower section of it. This is called a low-transverse uterine incision.

In rare circumstances, the doctor will opt for a vertical or "classical" uterine incision. This might be the case if your baby is very premature and the lower part of your uterus is not yet thinned out enough to cut. (If you have a classical incision, it's unlikely that you'll be able to attempt a vaginal delivery with your next pregnancy.)

 

Then the doctor will reach in and pull out your baby. Once the cord is cut, you'll have a chance to see the baby briefly before he's handed off to a pediatrician or nurse. While the staff is examining your newborn, the doctor will deliver your placenta and then begin the process of closing you up.

After your baby has been examined, the pediatrician or nurse may hand him to your partner, who can hold him right next to you so you can admire, nuzzle, and kiss him while you're being stitched up, layer-by-layer.

The stitches used for your uterus will dissolve in the body. The final layer – the skin – may be closed with stitches or staples, which are usually removed three days to a week later (or your doctor may choose to use stitches that dissolve on their own). Closing your uterus and belly will take a lot longer than opening you up, usually about 30 minutes.

 

After the surgery is complete, you'll be wheeled into a recovery room, where you'll be closely monitored for a few hours. If your baby is fine, he'll be with you in the recovery room and you can finally hold him. You'll receive fluids through your IV until you can eat and drink.

 

If you plan to breastfeed, give it a try now. You may find nursing more comfortable if you and your newborn lie on your sides facing each other.

 

You can expect to stay in the hospital for about three days. Your doctor will talk with you about your pain medication. Most use a patient-controlled anesthesia, through your IV, followed by pain pills as necessary when you're able to eat and drink.