The Different Types of Cesareans

[CTRedSoxMom]

This week, the Unnecesarean is featuring 'The Best of" blogs as a flashback, which I think is a super awesome idea. Some blogs are really worthy of being shared more than once. So I figured I would share an adapted interpretation of "The types of Cesarean's" which is the post being revisited today.

Today the cesarean section rate is 31.8% and that number is even higher in my state, Connecticut, which is now up to 34.6% up from 34.1% as of 2006. Which makes myself and most people wonder, what is increasing this number so drastically. Some say that patient choice cesarean sections are driving this number up, which has been debunked. Others say that the lack of VBAC access is causing a huge problem, which I completely agree with. The number of VBAC bans across the country are way too high. Forcing women to have unnecessary surgery to deliver their babies, whether they wish for a natural birth or not. Which all in all is a huge violation of woman's rights in general, but that is a complete different topic all in all.

So, some of the different type of cesarean sections....

Planned = Non-Emergency
Not Planned = Emergency

We all know that going into labor on your own is beneficial for the baby. There is no disputing that, as long as the mother is healthy with no risk factors for any kind of emergency, then that should be the best route to take. Even when it comes to breech deliveries.
Why should we wait till women go into labor on their own?

• Labor indicates in most cases that the baby is ready to be born, and will likely not need any kind of NICU care, have any kind of illness or respiratory problems, and also will be more ready to breastfeed with more success.

Now lets look at a couple different types of cesarean sections..

Planned Cesareans:
Medical reason : The mother has made the choice to have a cesarean section for a condition such as placenta previa.
Elective : mother chooses without a medical reason. For example: fear of pain, or choice of choosing the child's birthday around the parents schedule.
Care Provider or Mother Convenience : Some care providers will even pressure mothers into a cesarean around a certain date for convenience, such as around a vacation schedule. A great blog about this trend....

Care Provider Necessitated/Pressured – Some planned cesareans, may have questionable reasons. For example: twins; breech; or suspected big baby.

Her OB says it is medically indicated so mom assumes it is, but if she was to do further research, she would find that she has other options. Many care providers allow twin births, breech births, believe babies grow to the perfect size for the mothers, etc.

Now we move onto unplanned cesareans....
Emergency due to natural causes – A life threatening situation to mom or baby. Time from decision to surgery would be less than 10 minutes. For example: placental abruption.
Urgent due to interventions - Medically indicated, but not currently life threatening. Typically the time from decision to surgery would be 20-60 minutes. For example: pitocin induced contractions causing distress to baby
Emergency due to interventions – A life threatening situation to mom or baby. Time from decision to surgery would be less than 10 minutes. For example: Breaking of water causes cord to prolapse.
Urgent due to natural causes - Medically indicated, but not currently life threatening. Typically the time from decision to surgery would be 20-60 minutes. For example: baby is showing distress due to cord issues.
Maternal Choice due to interventions – For example: not allowing food causes mom to feel nauseous and exhausted.
Failure to Progress (or Failure toWait) – progress may be slower than anticipated but mom and baby are doing fine. OB is ready to go home, or hospital has arbitrary “guidelines”. For example: mom can only push 2 hours.
Reluctant Mother Choice / Nothing Else Seems to be Working - This is for moms who have tried waiting hours, different positions. Mom and baby are still doing fine, but (usually because of baby positioning) no progress is being made and mom is told this is the way baby is coming out. So mom reluctantly goes forward.
Failed Induction – Your body was not ready to give birth or baby was not ready to be born. Often the care provider blames it on mom or baby. For example, “Oh this baby was just too big or your pelvis was too small. “ This can be damaging to mom, who may think her body doesn’t “work” Let’s say what it really is, your body and or your baby were not ready. Or more simply the induction did not work.

Now, these are frequently heard in our circles of friends, all the mothers who have had cesarean sections, at birth groups, on internet forums, and even at ICAN meetings. But people still seem to not understand the difference between these elective cesareans and the cesarean sections that are truly necessary for medical reasons.
I must stress, having a cesarean section previously is NOT a medical reason to have a repeat cesarean section. In fact, despite what many OB/GYN's and medical professionals will say. VBAC is safer in low risk, healthy women with uncomplicated pregnancies, which is a large population of women who have had previous cesarean sections. Many doctors are practicing defensive medicine today, which "if you section them, they can't fault ya" and when I say that, I saw that come out of an OB/GYN's mouth with my own two eyes. It is not something I made up along the way. If you want to watch it too, just pick up a copy of The Business of Being Born.
Women become automatically defensive when I make the above statement about repeat cesareans. Which I will never be able to wrap my mind around. As mothers, you would think these same women would research this topic and learn for themselves instead of blinding trusting any provider, especially if they encouraged your first cesarean. The recovery from a cesarean section is no walk in the park. Believe me, I know, I have been there, TWICE. I would take my VBAC attempt 26 hour labor any day, over another cesarean recovery. They could have split me open like a log with an ax going through it, and I would have still been grateful to not have to have a second cesarean.
But as I said all along, I am not a martyr, and I would not cost my child his life in order to have a VBAC. I have had both experiences. A completely unnecessary cesarean, and a truly necessary, medically needed, life saving cesarean. And I am grateful for both experiences.
Without those experiences, I would not be where I am today. I would not be an ICAN chapter leader and Regional Coordinator. I would not be heading a huge maternity care project in my state, and I wouldn't be the mother of the most amazing two boys I have ever met.

Long story short, our country is in need of a serious change. These cesarean rates are dangerous and they are killing mothers and babies. But hush hush, keep that on the down low because if we actually blew up ACOG's spot, they would lose millions in all these unnecessary cesareans!
To bad women couldn't sue over an unnecessary surgery huh?

[mommypip]

Sep. 24, 2009 at 11:23 PM

Awesome journal!

[mama4Christ361]

Sep. 25, 2009 at 10:20 AM

And THIS is why I am terrified to give birth again! The pain comes and goes, and you honestly don't remember it once you get your baby in your arms--but giving birth anywhere but at home, with a midwife or doula? Good gravy, it's something Stephen King would come up with! Any suggestions on how to find someone willing to deliver me at home in my area?

[CTRedSoxMom]

Sep. 25, 2009 at 11:40 AM

First things first Mama4Christ, Doula's do not deliver babies, and they are not medical care providers. They are strictly support people. As far as finding a midwife to deliver you at home, all you have to do is google home birth midwife and your state, and you should be able to find a list of midwifes. Where do you live?

(Original Poster)

[emslala]

Sep. 25, 2009 at 4:11 PM

Just out of curiosity, what would you classify PROM as? The "medical standard" is to be in active labor or (preferably) have the baby within 24 hours of the water breaking. I disagree with that, but that's JMO. I don't know if that would be Failure to Wait or Provider Convenience... I think a little of both, honestly.