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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Sep 20
    2010

    pregnancy & maternal heart condition - need a Cesarean?

    Archived User

    Hello, Henci, I had an inquiry for doula care. The mom to be has a congenital heart abnormality and has been told she may need a Cesarean section as opposed to laboring. She is being monitored in her pregnancy and her aorta is enlarged now at 26 weeks.
    Do you know of any studies or research that she can find to help her with a decision? I've been looking on the net but haven't found much yet.
    I remember years ago I thought there had been a short video done on women who had heart conditions and birthed squatting and without adding any extra pushing or effort and they all did fine.
    I know one must take each woman individually yet am curious about any data out there to support trying at least with some labor first as opposed to straight to a Cesarean.  As well, I think one would want to look at the risks of Cesarean with a heart abnormality too. What would be the caregivers concern regarding laboring?
    Thanks in advance for any links or resources.

    Sincerely, Debra

    Henci Goer

    My area of expertise is in best practices for women free of medical complications, so I don't have any research to recommend. The best I can suggest is for your client to find an ob with a commitment to vaginal birth (overall c/sec rate 15% or less, promotes VBAC) and get his or her opinion based on this mom's particular condition and its severity. If a pro vaginal birth ob recommends planned c/sec, then she can trust the ob's judgment. If a cesarean is recommended, the benefits vs. harms of awaiting spontaneous labor onset should be part of the discussion. Since a cesarean seems likely, the International Cesarean Awareness Network website has a section on planning a family centered cesarean that you and your client may find helpful.   

     
    -- Henci

    All Times America/New_York

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