It's Cesarean Awareness Month - But Why?

April is Cesarean Awareness Month. If you're a first-time pregnant parent, you probably know at least one person who's had a cesarean. Do you know your own risk factor for having a c-section? Do you know why it even matters? Answers to these questions, and more, are exactly why we dedicate an entire month to cesarean awareness. 

Learning about the ins and outs of cesarean helps you understand your choices as you approach birth. Did you know, according to information from the International Cesarean Action Network (ICAN), that:

• Almost half of the cesareans performed could be safely prevented
• Cesareans can be “family friendly” depending on the practices and protocol of your hospital and care provider 
• Preventable cesareans may be responsible for up to 20,000 major surgical complications a year
• Cesarean present risks to future pregnancies and children, which are not often mentioned

When you know how to spot the difference between a c-section that's needed and being recommended for evidence-based medical reasons versus one that is being recommended for reasons that don't align with best medical evidence/practice, you can reduce your risk of having an unnecessary cesarean and the risks that come along with the procedure. Of course, when a cesarean is necessary, it can be life saving and the benefits far outweigh the risks. 

The following are evidence-based medical reasons for needing a cesarean:

• You are hemorrhaging.
• Your baby’s oxygen supply is blocked.
• You have placenta previa.
• Your baby is in a transverse position (lying horizontally across your pelvis).
• You have poorly controlled diabetes or severe pregnancy-induced hypertension.
• You’ve had a previous cesarean and your caregiver is unwilling to attend a vaginal birth after cesarean (VBAC) or your hospital doesn’t have round-the-clock anesthesia services.
• Your labor is not progressing at all, and either you or your baby is not doing well.
• Your baby is in a breech position (head up, feet or buttocks down) and your caregiver isn’t skilled at assisting vaginal breech birth.
• Your baby’s heart rate slows and doesn’t improve when you change position, drink more fluids, breathe some oxygen or turn your Pitocin down or off.
• You’re carrying more than one baby, and one of your babies is in a transverse position or your caregiver isn’t skilled at assisting vaginal multiple births.

Your doctor suspecting that your baby is "too big" is not an evidence-based reason to have a cesarean. Other reasons given for a c-section that fall outside of the list above may be outdated, for convenience, or otherwise not evidence-based. If you suspect your care provider is suggesting a c-section for non-medical reasons, first ask your provider about alternative options. Then ask, what would happen if we wait or do nothing right now? If you feel like your provider is pressuring you into a cesarean for non-medical reasons, consider seeking a second opinion and/or changing providers, if possible.