5 Ways to Reduce Your Risk of Cesarean

Around 1 in 3 babies are born via cesarean section in the United States. While abdominal birth is sometimes necessary and life-saving, the percentage of babies born this way should be closer to 10-15%.

Here’s what the American College of Obstetricians and Gynecologists (ACOG) has to say:

“In 2011, one in three women who gave birth in the United States did so by cesarean delivery. Cesarean birth can be life-saving for the fetus, the mother, or both in certain cases. However, the rapid increase in cesarean birth rates from 1996 to 2011 without clear evidence of concomitant decreases in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused.”

Cesarean surgery comes with additional risk in the present moment but also for any subsequent births. The benefits of a necessary cesarean outweigh these risks. But birthing people and babies are subjected to increased health risk FOR NO REASON (other than maybe a perceived reduction in financial risk for providers and institutions) when cesarean surgery is used inappropriately.

So what can you do to reduce your own risk? Here are five ways:

1. Practice “proactive patience” if the first stage of labor is progressing slowly.

The number one reason for first-time cesareans is “failure to progress”. Understanding that “failure to progress” is often just “failure to wait” on the part of your provider is important. But the reality of a long first stage is that it can be exhausting. And it can be really stressful and frustrating to experience the intense sensations of labor for long periods of time and find out there has been no change at all to your cervix. I have been there, and, honestly, it felt utterly defeating. So patience alone may not be enough when progress has slowed or stalled. Having ideas for strategies to try (like relevant labor positions) when a more proactive approach is needed can be really beneficial.

2. Learn more about your options for fetal monitoring.

The number two reason for first-time cesareans is “non-reassuring fetal heart tones”. Routine use of continuous electronic fetal monitoring is widespread, not evidence-based, and is a contributing factor. Alternatives, like intermittent ausculation, can reduce your risk of unnecessary cesarean surgery. Make sure to discuss your options with your care provider in advance.

3. Choose wisely when it comes to your care provider.

Choose a care provider that practices evidence-based care, respects birth physiology, and supports shared decision-making. This is one of the most important decisions you can make for your birth experience, because it affects your labor will be managed and which preferences will be available and supported. Most people give birth under the care of an obstetrician (experts at managing complications), but midwives (experts in supporting physiologic birth) are a great alternative to consider.

4. Research your options when it comes to birth location.

Find out what the cesarean rates are at any hospitals you are considering. It can vary widely (thanks to hospital policies that aren’t always evidence-based). You can also explore your options for out-of-hospital birth (birth center or at home). What’s available will depend on where you live and on your health insurance plan.

🔗 Your Biggest C-Section Risk Might Be Your Hospital | Consumer Reports

5. Hire a doula!

Doulas are trained labor support people, and research shows they reduce the risk of cesarean. While not medical professionals, they can help with non-medical comfort measures, suggesting which labor positions could be beneficial, advocacy, and so much more. Also, doulas don’t replace your spouse or partner. They just add an additional layer of support.

What If I’ve Had a Cesarean in the Past?

If you’ve had a prior cesarean, you may have options for avoiding another one in the future. It’s possible to have a vaginal birth after cesarean (VBAC). If you decide this option may be for you, it’s REALLY important to find a care provider and birth location that is actually supportive of VBAC. The website below is a great resource for learning more about VBAC:

🔗 VBAC Facts®

What if I really do need a cesarean?

While it’s so beneficial to take action in reducing the risk of cesarean, there are times when it is absolutely appropriate and life-saving. One thing I really want to emphasize is that cesareans themselves are not the problem. A cesarean birth is not a failure. The goal here is never to avoid necessary medical interventions. The problem lies with the OVERUSE of this medical intervention. This is a really important distinction.

But when plans have to change, a wide range of emotions is normal. Should a cesarean become necessary, it can he helpful to have your decisions documented on a birth plan. There are ways to enhance the experience to feel more like a family-centered birth and less like a medical procedure.

Avoiding medical interventions you don’t want or need is important for your birth. It can help to think about what you do want for your experience. I have a quiz and free resource to help you learn more about how you might want to approach navigating labor and birth. Click the button below to take the quiz!

Discover and Explore Your Birth Journey Archetype!