How To Avoid a Caesarian or C-Section Birth

C-Sections are epidemic in the United States. 1 out of every 3 women who is pregnant right now will have one. If you need a C-Section to save the life of your baby, it's nothing short of miraculous, and worth every bit of pain and risk.

Sometimes if your baby is breech and can't be turned, or in some cases with twins, a caesarean tremendously lowers the risk to your baby.

If you and your health care adviser have decided that a C-Section is warranted for safety reasons, you'll be scheduling it. Obviously, you'll want to choose a care-giver who's very experienced with C-Sections and a hospital with an excellent record.

But are you aware that C-sections:

1. Are major abdominal surgery with all the attendant pain and possible complications in the following weeks, just when you want to enjoy your new baby?
2. Increase your risk of hemorrhage and infection?
3. Result in a uterine scar and internal adhesions (scarring) that can cause pain and complications for years?
4. Increase your chances of later ectopic pregnancy and difficulty conceiving?
5. Increase your baby's chances of having asthma later in life?
6. Delay your breastmilk coming in, making it so much more difficult to breastfeed that many women give up?
7. Endanger the health of future pregnancies, increasing the chances of low birthweight, premature delivery and stillbirth?
8. Often leave women with medical complaints six months or a year later?

If you really need a C-Section, they are a miraculous life-saver. If you don't, it's best to avoid it.

Luckily, most C-Sections are not actually medically necessary. 85% of all pregnancies are normal and low-risk, and absolutely do not warrant C-Sections. In fact, there is absolutely no medical evidence that a caesarean is necessary just because you had one last time, or because you're over 40. Even with a multiple birth a C-Section is often more dangerous than a vaginal birth.

Most importantly, do you know that you can tremendously reduce your risk of C-section by picking a care-giver who uses certain kinds of birth practices?

VBAC

(Vaginal birth after caesarean) If you had a C-Section last time, you can still have a Vaginal Birth this time. Do you know the most decisive factor in whether a woman can successfully have a VBAC ? Age. But not the age of the mom, or the term of the baby. The age of the doctor!

That's because doctors used to be educated with the misinformation that uterine rupture was more likely with a VBAC. But the New England Journal of Medicine published a landmark study in 2004 showing that uterine rupture occurs in less than 1% of VBACs. In other words, a woman who had a C-Section is just as likely to be able to have a healthy vaginal birth as any other woman.

Are you over 40?

It's true that women over 40 have a 40% chance of having C-Sections, and it is exhausting and demoralizing to struggle through a prolonged labor only to end up in the operating room having a C-Section. BUT did you know that you can hugely increase your chances of being part of the 60% of over-40 year olds who have normal vaginal births? That's right. Most women over 40 do not need a caesarean, and can avoid having one.

Avoiding a C-Section: 
What every pregnant woman needs to know.

You can significantly reduce your chances of having a C-Section by informed choice of a caregiver and birth place. Here's how:

1. Exercise moderately during pregnancy.

Sedentary women are 4x as likely to deliver via caesarean section as women who did aerobics during the first or second trimester.

2. Find a caregiver who has a low C-Section rate

Find a caregiver who has a low C-Section rate and is experienced with successful VBACs. This is true even if you don't need a VBAC, because it means your caregiver doesn't default to caesareans.

3. Find a caregiver who will give you all the time you need

Find a caregiver who will give you all the time you need rather than rushing your delivery because of staffing issues.

4. Ask your caregiver what she does if your baby is in a breech position

Ask your caregiver what she does if your baby is in a breech position in late pregnancy. You want to hear that she is experienced with turning babies and always tries that before scheduling a C-Section.

5. Check Hospital policies.

If you're considering a VBAC, be sure to use a hospital that allows VBACs.

6. Arrange continuous trained labor support

Arrange continuous trained labor support which studies show keeps labor moving. If you aren't using a midwife, supplement your OB by hiring an experienced labor doula. A 2001 study in the journal of perinatal education showed a 56% reduction in the risk of caesarean in women receiving continuous one to one nursing/doula or midwifery care.

7. Be sure that your caregiver and birth venue encourage practices that support the normal process of labor and keep it moving:

• Arrange to stay upright and moving rather than lying down.
• Stay well-nourished and hydrated to give you energy
• Avoid continuous electronic fetal monitoring
• Avoid hastening labor with pitocin, which increases the severity of contractions and makes other medical interventions much more likely.

A Guide for First-Time Parents

You've survived 9 months of pregnancy. You've made it through the excitement of labor and delivery, and now you're ready to head home and begin life with your baby. Once home, though, you frantically realize you have no idea what you're doing!

These tips can help even the most nervous first-time parents feel confident about caring for a newborn in no time.

Getting Help After the Birth

Consider getting help during this time, which can be very hectic and overwhelming. While in the hospital, talk to the experts around you. Many hospitals have feeding specialists or lactation consultants who can help you get started nursing or bottle-feeding. In addition, nurses are a great resource to show you how to hold, burp, change, and care for your baby.

For in-home help, you might want to hire a baby nurse or a responsible neighborhood teenager to help you for a short time after the birth. Your doctor or the hospital can be good resources for finding information about in-home help, and might even be able to make a referral to home health agencies.

In addition, relatives and friends often want to help. Even if you disagree on certain things, don't dismiss their experience. But if you don't feel up to having guests or you have other concerns, don't feel guilty about placing restrictions on visitors.

Handling a Newborn

If you haven't spent a lot of time around newborns, their fragility may be intimidating. Here are a few basics to remember:

• Wash your hands (or use a hand sanitizer) before handling your baby. Newborns don't have a strong immune system yet, so they are susceptible to infection. Make sure that everyone who handles your baby has clean hands.

• Be careful to support your baby's head and neck. Cradle the head when carrying your baby and support the head when carrying the baby upright or when you lay your baby down.

• Be careful not to shake your newborn, whether in play or in frustration. Shaking that is vigorous can cause bleeding in the brain and even death. If you need to wake your infant, don't do it by shaking — instead, tickle your baby's feet or blow gently on a cheek.

• Make sure your baby is securely fastened into the carrier, stroller, or car seat. Limit any activity that could be too rough or bouncy.

• Remember that your newborn is not ready for rough play, such as being jiggled on the knee or thrown in the air.

Medical Care and Your Newborn

By the time you hold your new baby in your arms for the first time, chances are you've already chosen one of the most important people in your little one's early life — a doctor. You and your baby will probably visit the doctor more often during the first year than at any other time.

You may have had a prenatal visit with your baby's doctor-to-be to discuss some specifics, such as when he or she will see your newborn for the first time, office hours and on-call hours, who fills in when your doctor is out of the office, and how the office handles after-hours emergencies. You may have also learned the doctor's views on certain issues.

In this way, you've begun to forge a relationship with your baby's doctor that should last through the bumps, bruises, and midnight fevers to come.

What Happens Right After Birth

 
Depending on your desires and the rules of the hospital or birth center where your baby is delivered, the first exam will either take place in the nursery or at your side:

Weight, length, and head circumference will be measured.

Temperature will be taken, and your baby's breathing and heart rate will be measured.

The doctor or nurse will monitor skin color and your newborn's activity.

Eye drops or ointment to prevent eye infections.

A shot of vitamin K will be given to prevent the possibility of bleeding.

Your baby will be given a first bath, and the umbilical cord stump will be cleaned. Most hospitals and birthing centers provide personal instructions (and sometimes videos) to new parents that cover feeding, bathing, and other important aspects of newborn care.

The Doctor's Visit

 
The hospital or birth center where you deliver will notify your child's doctor of the birth. If you have had any medical problems during pregnancy, if any medical problems for your baby are suspected, or if you are having a C-section, a pediatrician or your baby's doctor will be alerted of the impending birth and be standing by to take care of the baby.

The doctor you have chosen for your newborn will probably give your baby a full physical examination within 24 hours of birth. This is a good time to ask questions about your baby's care.

A sample of your baby's blood (usually done by pricking the baby's heel) will be taken to screen for a number of diseases that are important to diagnose at birth so effective treatment can be started promptly. In some cases, a repeat sample to confirm the results will be taken by the baby's doctor soon after going home.

Every newborn should be seen and examined at the doctor's office within 3 to 5 days after birth and within 72 hours after discharge from hospital. But if your baby is sent home less than 48 hours after delivery, your doctor will want your baby to be brought to the office for a check within 48 hours after discharge.

The First Office Visit

During the first office visit, your doctor will assess your baby in a variety of ways. The first office visit will differ from doctor to doctor, but you can probably expect:

measurement of weight, length, and head circumference to assess how your baby's been doing since birth

observation of your newborn's vision, hearing, and reflexes

a complete physical examination

questions about how you are doing with the new baby and how your baby is eating and sleeping

advice on what you can expect in the coming month

a discussion of your home environment and how it might affect your baby's health (for example, smoking in the house can harm your baby's health in many ways)

Also, if the results of screening tests performed on your newborn after birth are available, they may be discussed with you. Bring any questions or concerns to the doctor at this time. Jot down any specific instructions given regarding special baby care. Keep a permanent medical record for your baby that includes information about growth, immunizations, medications, and any problems or illnesses.


Immunizations Your Baby Will Receive

 
Babies are born with some natural immunity against infectious diseases because their mothers' infection-preventing antibodies are passed to them through the umbilical cord. This immunity is only temporary, but babies will develop their own immunity against many infectious diseases.

Breastfed babies receive antibodies and enzymes in breast milk that help protect them from some infections and even some allergic conditions.

Infants should get the first shot of the hepatitis B vaccine before they leave the hospital. Since your baby will receive more immunizations over the coming months, you may want to familiarize yourself with the standard immunization schedule.

When to Call the Doctor

 
Don't hesitate to call your doctor if you have concerns about your newborn. Some common difficulties to be aware of during this first month:

Eye problems can be caused by blockage of one or both tear ducts. Normally the ducts open on their 

own before too long, but sometimes they remain clogged, which can cause tearing and eye discharge. 

Call your doctor if you suspect an eye infection.

Fever in a newborn (rectal temperature above 100.4°F or 38°C) should be reported to your doctor right away.

A runny nose can make it hard for a baby to breathe well, especially during feeding. You can help ease discomfort by using a rubber bulb aspirator to gently suction mucus from the nose. Call your doctor if you have concerns about your baby's breathing.

It's normal for newborns to have loose stools or spit up after feedings. However, very loose and watery stools and forceful vomiting could mean there is a problem. Call your doctor if your baby has diarrhea, is vomiting, or has signs of dehydration, which include a decreased number of wet diapers, a dry mouth, and lethargy (being very sluggish or drowsy).

by: Mary L. Gavin, MD

How to care for your new born baby

The moment your baby is born can be both magical and stressful. A newborn experiences rapid change in physiology at birth and during the initial few days of life. This is the period when many infants would fall sick. So care during first few days of life is very important and can lay a good foundation for a healthy childhood. Irrespective of the mode of delivery, opportunity should be utilized for bonding and initiation of breastfeeding. Because separation of a normal infant from the mother even for a couple of hours can pose an effect on successful breastfeeding. 

Breastfeeding is the best way to provide infants with the nutrients they need. WHO recommends exclusive breastfeeding starting within one hour after birth until a baby is six months old. Once you are ready for discharge from the hospital make sure that your kid gets all the vaccinations (BCG, OPV & Hepatitis B). The infant can be bathed at home once discharged from the hospital. A variety of traditional practices are common in India.

 These can be beneficial such as oil massage, however there are a variety of harmful traditional practices such as applying kajal/surma in eyes, putting oil in ear and nose, putting boric acids in nostrils or applying substances such as cow dung on cord must be avoided. All healthy babies should preferably be placed down for sleep on their back only. If your baby’s birth weight is below 2000 grams then you can do kangaroo mother care (KMC), in this method the infant is placed between mother’s breasts in direct skin-to-skin contact because of benefit on breastfeeding, better weight gain, and lower risk of respiratory infections.

 Author,

Dr. Kumar Ankur