A Beautiful C-Section, Doula Woman Ponders the Possibility

If you were to ask me before I saw this video about a Natural C-Section, I would have told you that a natural c-section was an oxymoron. How could major surgery be natural. The only way I would use those words in a sentence would be, “She was given intervention after intervention; induced, laid flat on her back throughout and was not allowed food or drink, naturally she had a c-section. This video however has given me pause. Not every woman can or will have a normal birth. Sometimes there truly are reasons that a woman needs to have this operation, here is a list of reasons according to health pages:

Cesarean births are most often performed for two main reasons:

  • the danger to the mother or baby would be greater with a vaginal birth
  • things go unexpectedly wrong during a vaginal delivery

The following reasons fall under these two main reasons:

  • Dystocia. The number one reason for cesarean birth is ‘dystocia.’ Dystocia refers to any difficulty in labor. The difficulty can be caused by:
    • The fetus is not be able to progress down the birth canal. Failure of labor to progress can be caused by contractions that aren’t vigorous enough to open the cervix (dilate) enough for the baby to move through the vagina or the baby presents other than crown first that prevents progress through the birth canal. Failure to progress accounts for about 1/3 of all cesarean births.
    • The size of the baby compared to the size of the mother’s pelvis—if the baby’s head is too big to pass through the mothers pelvis it can cause a very difficult vaginal delivery and even stop the cervix from completely dilating. In some cases, the pelvis may be misshapen or the baby presents the largest part of the head instead of the crown and it’s too large for the pelvis. Some babies are just too big to be born vaginally; large babies are common with gestational diabetes.
    • Weak contractions in the mother’s uterus; strong contractions are needed to push the baby out from mother’s womb. Extended labor can be a risk to both the mother and the baby, more so to the baby.
    • Your baby’s head is in the wrong position or presentation—the normal position at birth would be head down with the back (crown) of the head leading the way—called the cephalic presentation. This presentation makes your baby the “smallest.” If your baby presents face first or forehead first, your pelvis may not be large enough for your baby to get through.
  • Obstruction or severe distortion of the birth canal (caused by pelvic tumor or fibroid tumors)
  • Previous cesarean birth. There is a common saying “once a cesarean, always a cesarean.” This thinking led to an large increase in cesarean birth rates. This used to be true since most surgeons used the classical cesarean incision that had more blood loss and left weak incision sites. Weak incision sites made ruptures more common in later pregnancies. Recently, the low transverse uterine incision has become more common reducing the risk of rupture and enables a mother to try a vaginal delivery after cesarean (VBAC).
  • Position of the fetus within the uterus. The normal position just before the delivery is a head-down (cephalic) position. If the baby presents in one of the positions listed below, vaginal delivery could lead to the trauma or death of the fetus. Sometimes the baby can be turned to allow vaginal delivery. Problems can also arise when the umbilical cord is “born” before the baby, cutting off the baby’s blood supply.
    • Breech presentation. When the fetus is in a head-up, feet-first or rump-first position it’s called a breech presentation. The breech position can be further classified as frank (hips are bent and knees are straight), complete (knees and hips are bent), footling (knees and hips of one or both legs straight) or incomplete (one or both hips bent and one or both feet or knees lying below the breech).
    • Shoulder. There are many shoulder presentations, however, all transverse positions (sideways) are called shoulder presentations.
    • Compound. When two body parts appear at the pelvis at the same time, such as a hand beside the head, it’s called a compound presentation.
  • Fetal distress is used to describe any complications with the fetus—such as abnormal heart rate from poor oxygen supply—and usually does not allow vaginal delivery. In most cases, fetal distress is lack of oxygen to the brain of the fetus (oxygen deprivation). Lack of oxygen can be caused by the umbilical cord is compressed or there are problems with the placenta, cutting off the blood supply to the fetus. Lack of oxygen can be diagnosed by monitoring the fetal heart rate. Lack of oxygen can cause very serious complications if the fetus is not delivered right away. Cesareans can also be necessary in cases of congenital (at birth) abnormalities of the fetus.
  • Multiple births. When there is more than one fetus most surgeons deliver by cesarean births. Cesarean birth is a much safer method to deliver multiple babies. About half of all mothers who have twins, have a c-section, while 90% of triplets are born by c-section.
  • Very premature fetus.
  • Problems with the Umbilical When the umbilical cord is delivered ahead of the fetus, called cord prolapse, it causes the cord to get compressed by the baby and oxygen and the blood supply to the baby is cut off. This is an emergency that requires cesarean birth. Sometimes, the cord can be completely delivered and if the baby is coming right behind it, you may be able to have a vaginal birth. If the cord is around the baby’s neck, contractions can compress the cord causing the blood flow—and therefore oxygen—to your baby to slow down.
  • Problems with the Placenta. The placenta can detach from the uterine wall (abruptio placentae) before labor begins and be life threatening for both you and your baby. Placenta previa is when the placenta partially or completely blocks the opening of the cervix. In this case, the placenta would have to be born first, leaving the fetus without oxygen. In addition, blood loss for the mother could be fatal.
  • Health of the Mother. Certain health conditions of the mother can require a cesarean birth:
    • History of previous problems during childbirth
    • Active herpes sores
    • Narrow cervix (vaginal atresia)
    • Gestational diabetes
    • Pregnancy-induced hypertension
    • Vaginal infections or tumors
    • HIV
    • Cervical cancer
    • Heart disease or risk of stroke
    • Severe obesity
    • Repeat Miscarriages: Mothers who have had repeat miscarriages in the past usually have weak uterus may need a medical procedure to stitch the cervix closed. If the stitches are in at the time of labor, the only way of delivering the baby is by cesarean.
    • Rh Factor: In erythroblastosis fetalis (difference in the Rh factor of the mother and the fetus), there is a risk of fetal anemia.
  • Health of the Baby. If your baby has been diagnosed with health problems, it may be better for your baby to be born by cesarean birth. Also, monitoring during labor will tell how well your baby is handling labor and how well the placenta and umbilical cord are working

Many of these complications happen in a very small number of births. And the decision for cesarean birth is decided by balancing the risks and benefits to mother and baby.

If you are someone who falls into the category of having to have a planned cesarean  consider this type of surgery. It is woman centered and conscience of the needs of the infant. Do I think that this birth is preferable to the usual cut ’em out drag ’em out every-day-occurrence c-section? Yes, yes I do. When women and children are taken into consideration it can be a beautiful thing.



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