How many times have you heard women telling stories about their cesarean and the term “emergency” was included? Emergency: a serious, unexpected, and often dangerous situation requiring immediate action.
Did you know in the United States only about five percent of cesareans are a true emergency? (cnn.com) Then why do we as mothers hear these stories over and over again?
We know that interventions presented during your labor may often increase the risk of cesarean by 35-50%. And that the likelihood of you getting induced in a hospital setting is 22%. (ncbi.nlm.nih.gov) Epidurals and Pitocin are the next two culprits of increased cesareans. But are these cesareans emergencies? How do you really know?
Look around the room. Is your care provider stating you need a cesarean because you have been in labor a long time with little progress? Your baby is too big? You’re exhausted and your water has been broken for “x” amount of hours? If you haven’t already had an epidural placed, are you prepped and taken to the operating room and then have an epidural or spinal placed? These are not emergencies.
Is there immediate commotion in the room, extra hospital staff rushing in to assist? Do you see panic on their faces? Are you gassed to sleep in the operating room? THAT is an emergency. See the difference?
Tip: Change Positions
Fetal heart rate distress is the primary cause. If your baby’s heart rate does not bounce back up after the contraction ends, this is a cause of concern. Often changing positions can return enough oxygen to your baby and return the heart rate back to normal, however if this continues, the watch and assess approach becomes a sense of urgency.
Here are two real-life experiences as a doula, which I have witnessed:
My client was planning a VBAC (vaginal birth after cesarean) for her second child. She went into labor on her own and without any pain medications along the way. She made it to pushing! We thought, this was it; she’s getting her VBAC! But then while pushing, the fetal heart rate was dipping continuously into the 60’s (extremely low), a cause for concern. Even with position changes, it continued. With not enough progress made during pushing, my client was immediately wheeled into the operating room without having her husband or myself able to go in with her, she was placed under general anesthesia, and the cesarean was performed. True Emergency.
My client reached nine centimeters with her first child. She had been at nine for a little while. Baby was posterior. The care provider came in and stated there had been some decelerations in the fetal heart rate that are starting to become a concern. However, with position changes, they would bounce back up. My client was checked again a short time later with “no progress.” Care provider stated she needed to have an emergency cesarean because of these decelerations. Nurse came in and prepped my client (shaved and cleaned). Another nurse came in and stated that my client’s surgery was delayed due to another emergency cesarean. We waited. The first nurse that prepped my client had already taken off the electric fetal monitor and had my client on the gurney to be wheeled to the O.R. Nurse came back in stating we were “bumped” again due to another emergency cesarean. We waited some more. No monitoring being done this entire time for the baby whose heart rate was of concern? She finally went in for her surgery, spinal placed. Unfortunately, not an emergency.
In 2011 a group on moms started Improving Birth, whose mission is to bring evidence-based care and humanity to childbirth. Currently, the group expanded to become internationally known for its continuous work with advocating and educating women and families. There is even a link on their website to file a complaint regarding your care or previous birth experience. Together we can break the silence and prevent other women to experience negative or traumatic births. Find out more information at www.improvingbirth.org
“Just like there’s always time for pain, there’s always time for healing.”
I am a certified birth doula in the central New York area. I am a founder of the CNY Doula Connection. I also offer postpartum care, childbirth education classes and trainings, lactation support, belly binding, and placenta encapsulation and training in the greater Syracuse area.