Lots of families come into my childbirth classes asking how they can reduce their risk of having a cesarean birth. We talk about what the research has clearly indicated, which includes:

-Get good prenatal care, eat well, exercise, go into labor as healthy as possible

-Stay at home during early labor

-Avoid medical interventions, especially induction and continuous fetal monitoring, unless medically indicated.

-If a mom wants an epidural, wait until labor is well established (5cm or more)

-Wait until the baby is low enough before pushing

-Hire a birth doula

One thing that has not come up in the articles or research though is something that needs to happen way before all these things… and that’s CHOOSE A PROVIDER WHO HAS A LOW CESAREAN RATE. My students are often surprised to hear that while our cesarean rates at our local hospital here in Austin typically fall into the “average” range matching the national averages, the rates actually vary greatly from physician to physician. A recent article in the Science and Sensibility blog outlines some research which shows clearly that provider attitudes vary greatly, and that does indeed influence their recommendations when it comes to making decisions about performing a cesarean. https://www.scienceandsensibility.org/blog/providers-support-vaginal-birth?source=1&utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+science-sensibility+%28Science+%26+Sensibility%29

What can you do? Ask your provider about their cesarean rate for low risk, first time moms who have a head down baby at full term. (This is known as the NTSV rate) Find out how this rate compares to the “target” rate of 24%… Ask him/her the reasons they usually do cesareans, and their general attitude about cesareans. You’ll get a feel for things, and if they seem to not be in alignment with your beliefs, you may be better off finding another provider.

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How does a doula really make a difference?
Results from different studies have all suggested that having a doula reduces the overall cesarean rate by 50%, Pitocin use by 40% and requests for epidurals by 60%. The use of a doula also showed a major reduction in the length of labor due to fewer stress hormones being produced in the laboring woman’s body.

The Doula Book © 2002; Klaus, Marshall, Klaus and Kennell.