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This article, from The March of Dimes, is for women thinking about scheduling their baby's birth.  If your pregnancy is healthy, wait for labor to begin on its own.  We know you can’t wait to meet your baby face to face.  But getting to at least 39 weeks gives your baby the time he needs to grow. Healthy babies are worth the wait!  There are lots of important things happening to your baby in the last few weeks of pregnancy.  For example, your baby's brain and lungs are still growing. 

Why scheduling an early birth can be a problem: 

Experts are learning that scheduling an early birth for non-medical reasons can cause problems for mom and baby. For example:

-Your due date may not be exactly right. Sometimes it's hard to know just when you got pregnant. Even with an ultrasound, your due date can be off by as much as 2 weeks. If you schedule to induce labor or schedule a cesarean birth (also called a c-section) and your date is off by a week or two, your baby may be born too early.

-Inducing labor may not work. If your labor is induced, the medicine your doctor or certified nurse-midwife  gives you may not start your labor. When this happens, you may need to have a c-section.

-A c-section can cause problems for your baby. Babies born by c-section may have more breathing and other medical problems than babies born by vaginal birth. (Most babies are born by vaginal birth. The mother's uterus contracts to help push the baby out through the vagina, also called the birth canal.)

-C-sections can cause problems in future pregnancies. Once you have a c-section, you may be more likely in future pregnancies to have a c-section. The more c-sections you have, the more problems you and your baby may have, including problems with the placenta. 

-A c-section is major surgery for mom. It takes longer for you to recover from a c-section than from a vaginal birth. You can expect to spend 2 to 4 days in the hospital after a c-section. Then you'll need 4 to 6 weeks after you go home to fully recover. You also could have complications from the surgery, like infections and bleeding. So it's important to stay in touch with your health care provider even after you go home.

Questions to ask your provider: 

If you’re planning to schedule your baby’s birth, print out this article and take it with you to your next prenatal care checkup. Ask your provider these questions:

If your provider recommends that you have your baby before 39 weeks:

-Is there a problem with my health or the health of my baby that may make me need to have my baby early?

-Can I wait to have my baby until I’m closer to 39 weeks?

About inducing labor:

-Why do you need to induce labor?

-How will you induce labor?

-Will inducing labor increase the chance that I’ll need to have a c-section?

About c-section:

-Why do I need to have a c-section?

-What problems can a c-section cause for me and my baby?

-Will I need to have a c-section in future pregnancies?

Recent medical guidelines state that women with one previous low-transverse incision should be treated the same as the woman without a previous cesarean! Professionals now even recommend that women with two or more cesareans can have a VBAC if they wish.

Many women want to have a VBAC because of the feeling that they missed out on an important life experience when they had a cesarean. They want to feel a baby move through and out of their bodies and into their arms. Other women and medical professionals know that labor is important for the newborn's adjustment to life outside mother. They also know that vaginal births are safer for mothers and infants than planned cesareans. Still others want a faster recovery from their births and to go home much sooner than when they had a cesarean. They want to mother and nurture their infants (and other children) without the restrictions that accompany surgical delivery. They want to avoid surgery and its risks and complications.

You may share these reasons or have different ones, but it's important to remember that any reason to want a VBAC is a good reason.

What do I need to know about my previous cesarean?

It's helpful to know why you had your cesarean(s). Most reasons for a cesarean don't necessarily repeat themselves. These include:

Fetal distress - baby in trouble;

Cephalopelvic disproportion (CPD) - "too-big baby for too-small pelvis;"

Failure to progress - labor lasts too long;

Breech position - baby comes bottom or feet first;

Transverse - baby lies sideways;

Abrupted placenta or a placenta previa - location or separation of the placenta causing bleeding and problems with the baby's supply of oxygen;

Prolonged rupture of the membranes - the bag of waters breaks, and either labor does not begin or the baby is not born within a specified amount of time;

Previous birth(s) by cesarean - including planned, repeat cesareans.

Despite cesareans for the above or other reasons, countless women have successfully and safely had their later babies vaginally.

Please read the rest of this excellent article on The Health Pages website found here.

The International Cesarean Awareness Network, Inc. (ICAN), is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC).  Please visit the Central Arkansas group on facebook where you can learn about the local meetings!

~Doulas are a great resource when planning your VBAC birth.  Call the Birth Works office today at 501-663-2850~

The birth of a child is one of the most significant events in the lives of families. It is considered a rite of passage by many women, and involves the first interaction between parents and their baby. There is much buzz today about the necessity of making birth a “family-centered” experience, where the focus is often on creating a special environment for bonding between parents and child in the first moments and days of life. But what if you are one of the one in three women who experiences your baby’s birth as a cesarean section? Is it possible to make your surgical experience into a family-centered birth?

The answer is a resounding yes. While planning a family-centered cesarean is easiest for the woman who must, for whatever reason, schedule her baby’s birth, there are a number of ways that a woman who encounters an unplanned or even emergent cesarean surgery can make her experience into a celebration of her baby’s birth.

Become Familiar with the Procedure

It is first important that every pregnant woman and her partner become aware of the procedures that surround a cesarean surgery. Many women who experience unplanned cesarean deliveries lament that, “I skipped the section of the book on cesareans, I assumed it couldn’t happen to me!” Having some familiarity with the procedure and all that it involves can help reduce much of the surprise and fear that can surround the unknown. (For an excellent explanation of cesarean section go to http://www.ican-online.org/resources/white_papers/wp_cssurgery.htm)

If your cesarean is planned, it is important that you have the opportunity to fully discuss with your care provider the reasons for your surgery. Knowing that this surgery is the best choice for your or your baby can create a less tense environment for the delivery. If you desire a vaginal birth and feel that a cesarean surgery may be unwarranted for you, consider getting a second medical opinion that all medical consumers are entitled to.

Write a Birth Plan

Next, plan this birth just as you would a vaginal birth. Write up a birth plan including your preferences for the surgery as well as for yours and the baby’s postpartum care (See second article attached below, written by Connie Banack). In the case of a pre-planned cesarean, it is usually possible to schedule an appointment ahead of time with your anesthesiologist. He/she is the person who actually controls the environment of the operating room. For example, generally, women’s arms are strapped down for their surgeries, so that they do not dislodge IV wires or sully the sterile surgical field. Ask if you can have at least one of your arms free – or have your support people hold your arms in place.

Discuss the pros and cons of both epidural and spinal anesthesia as well as the effects of various other medications you may receive both during and after the surgery. Some of the medications that treat specific symptoms such as trembling and nausea may cause extreme drowsiness or amnesia. You may decide that you would rather tolerate these symptoms than be asleep for the first few hours of your baby’s life.

When you write your birth plan and discuss it with your care providers, there are a number of things you may want to consider. Many women negotiate to have two support people with them in the operating room, generally their partner and a doula or friend and family member. Doulas are a great addition to a cesarean birth team. They are familiar with the process and can reassure you and your partner. Additionally, if you and your baby need to be separated at any point, your partner can accompany the baby while your doula stays with you. Doulas also often have some expertise in post-cesarean breastfeeding and can help with this.

Click here to read more of this excellent article by Michelle Smilowitz. 

BBC news also had a great article on the "Natural Cesarean".  Click here to read how to make a scheduled cesarean section more mother and baby friendly.  The slide show can be found here.

~A certified doula at Birth Works can help you to have a well-informed, beautiful cesarean section.  Give us a call today 501-663-2850~