Canada Moves to Stop Automatic C-Sections for Breech Babies

Speaking of options, I just came across this article on one of the birthing groups I get e-mails from. Canada is wanting to change their medical policies in regards to vaginal breech birth. Apparently, they will be giving mothers the option instead of just assuming that a cesarean section is the only safe way to deliver.

Here are a few parts from the article although I would highly recommend reading the entire thing:

"Breech babies account for about three to four per cent of all pregnancies in Canada, or about 11,000 to 14,500 pregnancies each year.

"Breech pregnancies are almost always delivered using a cesarean section, to the point where the practice has become somewhat automatic," Dr. Robert Gagnon, a principal author of the new guidelines and chair of The Society of Obstetricians and Gynaecologists of Canada's maternal fetal medicine committee, said.

"What we've found is that, in some cases, vaginal breech birth is a safe option and obstetricians should be able to offer women the choice to attempt a traditional delivery."
An international, Canadian-led study reported in 2000 that the safest way for breech babies to enter the world was via C-section. The study of more than 2,000 women found babies of mothers in the cesarean group were three to four times less likely to die, or have serious problems in the first six weeks of life, compared to those in the vaginal birth group (1.6 per cent versus 5.0 per cent).

The study had widespread influence worldwide. Many doctors stopped doing vaginal deliveries for breech babies, and many medical schools stopped training doctors in how to do them.But the doctor who led the study said the risks, while different, were never huge. "The risks were still quite low," says Dr. Mary Hannah, a professor in the department of obstetrics and gynecology at the University of Toronto and Sunnybrook Health Sciences Centre.

More recent studies, including a study of more than 8,000 French and Belgian women carrying breech babies, found no significant differences in risks to babies whether they were born vaginally or via C-section."

The new guidelines say that many breech deliveries will still require a C-section, and that a vaginal birth is not recommended for a "footling" breech, where the baby is positioned feet-first, with one or both feet pointing directly down toward the birthing canal.
Vaginal breech births also aren't recommended if the woman's pelvis is narrow or small, if the umbilical cord is likely to become entangled or compressed during delivery, or for babies that are too big (weighing more than 4,000 grams, or 8.8 pounds) or too small (less than 2,500 grams, or 5.5 pounds).

Breech deliveries are one of the main reason for C-sections, "and, if you do one (C-section), you increase the risk for another" in future pregnancies, Lalonde says. Repeat C-sections account for 30 to 40 per cent of all cesareans.

I think for most people a breech vaginal birth seems very foreign and down right scary. Before having my babies I knew nothing of it and didn't think it was ever done. When I found out that my daughter (twin A) was breech, I thought there wasn't any other option other than to have a c-section. I'm not sure what I would have done if I had the option and did the research.

It's definitiely a big decision to make. However, I do agree that women SHOULD have the option of a vaginal breech birth if they so choose, because it has proven to be safe in certain situations. Now to get our country on the bandwagon... Go Canada!

Options

Last month I was able to attend the monthly ICAN meeting that was held here in Phoenix. I was excited because May's topic was "Real Births after Cesarean". The purpose was to bring to light the real stories of vbac coming from the women who experienced them. None of the hearsay birth stories would be included.

I so much enjoyed listening to these women who had successful vbacs/hbacs here in Arizona. Each was unique in their circumstances, but they all had the same goal: A better birth experience and ultimately one that involved a vbac. The first woman had an un-medicated hospital birth (labored at home until ready to push) after one cesarean assisted by a CNM. The second had a VBA2C hospital birth assisted by a MD. The third had a home birth after 3 cesarean sections (HBA3C) assisted by a midwife and Naturopathic Doctor (legal here in AZ). These amazing women are inspirations to many including myself. I was so grateful that they were willing to share their birth experiences with others. This is just one of the many benefits that joining ICAN has to offer.

I personally know of many women who have had multiple c-sections and feel that they don't really have another option, other than to have another c-section. While it is a decision that only the mother can ultimately make, I think that it is SO important that they know that a vbac is STILL an option if they want it to be. Here is an article based on scientific research, that found vaginal birth after mutliple c-sections to be a safe option. There are Medical Doctors, Midwives, and Naturopathic Doctors out there who will assist in vbamc and have had success in doing so. It will most likely take a lot of extra work and preparation on your part, but it can and has been done.

Lastly, here is a video that I found on the blog Birth at Home in Az ,of several women who were able to achieve a successful vbac after mutliple c-sections.

A Balancing Act

I left to girls camp this last week to be a cabin mom/youth leader to the girls in my church. I was happy to get away for a little while and have a change of scenery. In a way I wanted to get away from all the normalcy's of life which included the birthing stuff. The e-mail lists, the blogs, the books, the shows. I just wanted to have a simplified day where I didn't think about birth. I didn't want to wonder if I'd get my vbac, if I'd find the right provider, if and when I will be ready for another pregnancy...delivery...baby. I guess I've felt a little overwhelmed lately which is my own fault as I can't seem to keep myself away from all the resources out there. I've felt myself begin to get overworked when reading things, especially those things that leave me feeling helpless in achieving what I really want. Unfortunately I allow these emotions to effect me and follow me throughout my day. At times it has effected my ability to be happy, and in turn concentrate on what needs attention right now {my family}. It's a balancing act that I'm continuously attempting to master.

I will admit that it felt good to just take a break from the birth junkie inside of me. I relaxed those parts of my brain and heart and just lived moment to moment. Because birth is something that effects every women and human for that matter, I should have guessed it would come up at some time while at camp. And alas, it did.

While waiting for my girls to finish their certifications a woman near bye began saying that she hoped she could have twins or triplets so she could have all of her kids at once and they could just "section them out" of her. Sadly, there wasn't much shock involved as I have heard these types of comments before. I kindly responded letting her know that a c-section isn't the easy risk-free option she thought it was. Short, simple, one sentence, and then I stopped. I didn't want to let it bother me, not here. I gently tucked my soap box away and continued on my day.

The next evening I sat at a dinner table with another woman who spoke about birth. She mentioned that she had 4 children; 3 unmedicated hospital births and then the 4th at the birthing center with a midwife. "What was it that made you want a birth at a birthing center instead of a hospital?" a friend of mine asked her. She then related how when her second child had been born, that the hospital staff felt that she wasn't breathing well enough and rushed her off to the ICU before she even got a chance to touch her. Five hours later, and after several tests, they found nothing wrong with the baby. After finally returning the baby to her mother and getting a chance to nurse etc., the baby started breathing normally again. Ouch...Instantly my heart began to hurt thinking of my own daughter being rushed to the NICU for breathing problems and staying there for 18 hours. After all the tests they told us that there was nothing really wrong and things just "fixed themselves." It was then that I finally got to hold her out of the NICU and nurse her for the first time. My eyes stung and began to water but I sucked it up. Not here, not now. I didn't say a word, just sat there looking down at my food. I knew if I said something that I would start to cry and this was not the place.

I have mixed feelings about being a "birth junkie." I love learning all there is about birth and hearing the amazing birth stories and it's something that I feel very passionate about. At the same time I hate the hurt that comes along with the bad memories and wondering whether I will be able to have a better birth experience. I hate having emotional wounds that still sting even though it's almost been two years. On the other hand, it's those bad experiences that drive me to work harder and compel me to be a "birth junkie" in the first place. It makes me wonder how some women find balance amongst everything that drives them in life.

Maternal Mortality in the USA

As I'm sure everyone has heard the heartbreaking news about our AZ Treasurer who lost his wife and newborn son due to complications during her delivery. My heart goes out to him and his family. While Kerry Martin's complications were very rare, I feel that this has definitely drawn attention to the subject of maternal mortality. I found a link to the following information from the most recent post at NursingBirth. This fact sheet originally came from The Safe Motherhood Quilt Project which aims at bringing awareness to the high maternal mortality rate in the US, as well as remembering those mothers who have died due to pregnancy related causes. I found this information to be very eye opening.

Maternal Mortality in the USA
A Fact Sheet

• The World Health Organization reported in 2007 that 40 other countries
have lower maternal death rates than the United States.

• The Centers for Disease Control (CDC) report that there has been no
improvement in the maternal death rate in the United States since 1982.

• The CDC estimated in 1998 that the US maternal death rate is actually 1.3
to three times that reported in vital statistics records because of
underreporting of such deaths. (1)

• The CDC reported in 1995 that the “magnitude of the pregnancy-related
mortality problem is grossly understated.” (2)

• The rate of maternal death directly related to pregnancy or birth appears
to be rising in the United States. In 1982, the rate was approximately 7.5
deaths per 100,000 live births. By 2004, that rate had risen to 13.1 deaths
per 100,000 births. By 2005, the rate was 15.1 deaths.

• The CDC estimates that more than half of the reported maternal deaths
in the United States could have been prevented by early diagnosis and
treatment. (1)

• Autopsies should be performed on all women of childbearing age who die
if there is to be complete ascertainment of maternal deaths.

• Numerous studies have found that in 25 to 40 percent of cases in which an
autopsy is done, it reveals an undiagnosed cause of death.

• In the 1960s, autopsies were performed on almost half of deaths.

.• The United States now does autopsies on fewer than 5 percent of hospital
deaths.

• Reporting of maternal deaths in the United States is done via an honor
system. There are no statutes providing for penalties for misreporting or
failing to report maternal deaths.

• In the United States, the risk of maternal death among black women is
about 4 times higher than among white women. For 2005, the rate was 36.5
deaths per 100,000 live births.

• Most countries with lower maternal death rates than the United States use
a different definition of “maternal death”, which, unlike the United States’
definition, includes those deaths directly related to pregnancy or birth
which take place during the period between six weeks postpartum and
one year after the end of pregnancy.

• Complete and correct ascertainment of all maternal deaths is key to
preventing maternal deaths.

• The Confidential Enquiry into Maternal Deaths in the United Kingdom
(England, Scotland, Wales, Northern Ireland), which has functioned since
1952, is the system believed to have achieved the most complete
ascertainment of maternal deaths while guaranteeing utmost
confidentiality. See http://www.cemach.org.uk/

• The maternal mortality rate for cesarean section is four times higher than
for vaginal birth and is still twice as high when it is a routine repeat
cesarean section without any emergency. (3,4)

• There is currently no federal legislation mandating maternal mortality
review at a state level.

• Fewer than half of the states conduct state-wide maternal mortality
review.

• Hospitals do not release reports of maternal deaths to the public; hospital
employees are required to keep such information to themselves.

• The Healthy People 2010 Goal is no more than 3.3 maternal deaths per
100,000 births. This is a goal that other nations have achieved.

Notes
1. Morbidity and Mortality Weekly Report, September 4, 1998, Vol. 47, No. 34.
2. Atrash HK, Alexander S, Berg CJ. Maternal mortality in developed
countries: Not just a concern of the past. Obstet Gynecol 1995;86:700-5.
3. Petitti D et al. In hospital maternal mortality in the United States. Obstet
Gynecol, Vol 59, pp. 6-11, 1982.
4. Petitti D. Maternal mortality and morbidity in cesarean section. Clin Obstet
Gynecol, Vol. 28, pp. 763-768, 1985.
5. The Confidential Enquiry into Maternal Deaths in the United Kingdom
www.cemach.org.uk
Prepared by Ina May Gaskin, MA, CPM
Coordinator for the Safe Motherhood Quilt Project
149 Apple Orchard Lane
Summertown, TN 38483
www.rememberthemothers.net
http://www.inamay.com/

For a great list of 10 ways to reduce your risk for complications in pregnancy and childbirth check out this post at NursingBirth.

Article from Time Magazine

Here is an article that was featured in Time Magazine back in February. I ran across it again today and wanted to share. I think it does a good job of shedding light on some of the challenges women are faced with when wanting a vbac in America, along with some of the reasons why there is so much resistance from doctors and hospitals.

(I highlighted some parts that really stood out to me)

The Trouble With Repeat Cesareans
By Pamela Paul Thursday, Feb. 19, 2009

To avoid another C-section, Barton has to drive 100 miles to deliver in Los Angeles.

For many pregnant women in America, it is easier today to walk into a hospital and request major abdominal surgery than it is to give birth as nature intended. Jessica Barton knows this all too well. At 33, the curriculum developer in Santa Barbara, Calif., is expecting her second child in June. But since her first child ended up being delivered by cesarean section, she can't find an obstetrician in her county who will let her even try to push this go-round. And she could locate only one doctor in nearby Ventura County who allows the option of vaginal birth after cesarean (VBAC). But what if he's not on call the day she goes into labor? That's why, in order to give birth the old-fashioned way, Barton is planning to go to UCLA Medical Center in Los Angeles. "One of my biggest worries is the 100-mile drive to the hospital," she says. "It can take from 2 to 3 1/2 hours. I know it will be uncomfortable, and I worry about waiting too long and giving birth in the car."

Much ado has been made recently of women who choose to have cesareans, but little attention has been paid to the vast number of moms who are forced to have them. More than 9 out of 10 births following a C-section are now surgical deliveries, proving that "once a cesarean, always a cesarean"--an axiom thought to be outmoded in the 1990s--is alive and kicking. Indeed, the International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs, up from 10% in its previous survey, in 2004. ICAN's latest findings note that another 21% of hospitals have what it calls "de facto bans," i.e., the hospitals have no official policies against VBAC, but no obstetricians will perform them. (Read "The Year in Medicine 2008: From A to Z.")

Why the VBAC-lash? Not so long ago, doctors were actually encouraging women to have VBACs, which cost less than cesareans and allow mothers to heal more quickly. The risk of uterine rupture during VBAC is real--and can be fatal to both mom and baby--but rupture occurs in just 0.7% of cases. That's not an insignificant statistic, but the number of catastrophic cases is low; only 1 in 2,000 babies die or suffer brain damage as a result of oxygen deprivation.
After 1980, when the National Institutes of Health (NIH) held a conference on skyrocketing cesarean rates, more women began having VBACs. By 1996, they accounted for 28% of births among C-section veterans, and in 2000, the Federal Government issued its Healthy People 2010 report proposing a target VBAC rate of 37%. Yet as of 2006, only about 8% of births were VBACs, and the numbers continue to fall--even though 73% of women who go this route successfully deliver without needing an emergency cesarean.

So what happened? In 1999, after several high-profile cases in which women undergoing VBAC ruptured their uterus, the American College of Obstetricians and Gynecologists (ACOG) changed its guidelines from stipulating that surgeons and anesthesiologists should be "readily available" during a VBAC to "immediately available." "Our goal wasn't to narrow the scope of patients who would be eligible, but to make it safe," says Dr. Carolyn Zelop, co-author of ACOG's most recent VBAC guidelines.But many interpreted the revision to mean that surgical staff must be present the entire time a VBAC patient is in labor. While major medical centers and hospitals with residents are staffed to provide this level of round-the-clock care, smaller hospitals typically rely on anesthesiologists on call. Among obstetricians, many solo practitioners are unable to stay for what could end up being a 24-hour delivery; others calculate the loss of unseen patients during that time and instead opt to do hour-long cesareans, which are now the most commonly performed surgeries on women in the U.S.

Some doctors, however, argue that any facility ill equipped for VBACs shouldn't do labor and delivery at all. "How can a hospital say it can handle an emergency C-section due to fetal distress yet not be able to do a VBAC?" asks Dr. Mark Landon, a maternal-fetal-medicine specialist at the Ohio State University Medical Center and lead investigator of the NIH's largest prospective VBAC study. (See 9 kid foods to avoid.)

Part of the answer has to do with malpractice insurance. Following a few major lawsuits stemming from VBAC cases, many insurers started jacking up the price of malpractice coverage for ob-gyns who perform such births. In a 2006 ACOG survey of 10,659 ob-gyns nationwide, 26% said they had given up on VBACs because insurance was unaffordable or unavailable; 33% said they had dropped VBACs out of fear of litigation. "It's a numbers thing," says Dr. Shelley Binkley, an ob-gyn in private practice in Colorado Springs who stopped offering VBACs in 2003. "You don't get sued for doing a C-section. You get sued for not doing a C-section."

Of course, the alternative to a VBAC isn't risk-free either. With each repeat cesarean, a mother's risk of heavy bleeding, infection and infertility, among other complications, goes up. Perhaps most alarming, repeat C-sections increase a woman's chances of developing life-threatening placental abnormalities that can cause hemorrhaging during childbirth. The rate of placenta accreta--in which the placenta attaches abnormally to the uterine wall--has increased thirtyfold in the past 30 years. "The problem is only beginning to mushroom," says ACOG's Zelop.

"The decline in VBACs is driven both by patient preference and by provider preference," says Dr. Hyagriv Simhan, medical director of the maternal-fetal-medicine department of Magee-Womens Hospital of the University of Pittsburgh Medical Center. But while many obstetricians say fewer patients are requesting VBACs, others counter that the medical profession has been too discouraging of them. Dr. Stuart Fischbein, an ob-gyn whose Camarillo, Calif., hospital won't allow the procedure, is concerned that women are getting "skewed" information about the risks of a VBAC "that leads them down the path that the doctor or hospital wants them to follow, as opposed to medical information that helps them make the best decision." According to a nationwide survey by Childbirth Connection, a 91-year-old maternal-care advocacy group based in New York City, 57% of C-section veterans who gave birth in 2005 were interested in a VBAC but were denied the option of having one.

Zelop is among those who worry that "the pendulum has swung too far the other way," but, she says, "I don't know whether we can get back to a higher number of VBACs, because doctors are afraid and hospitals are afraid." So how to reverse the trend? For one thing, patients and doctors need to be as aware of the risks of multiple cesareans as they are of those of VBACs. That is certain to be on the agenda when the NIH holds its first conference on VBACs next year. But Zelop fears that the obstetrical C-change may come too late: "When the problems with multiple C-sections start to mount, we're going to look back and say, 'Oh, does anyone still know how to do VBAC?'"

On Being Prepared

A few weeks ago I began questioning myself as to why I was preparing so much ahead of time for my vbac and taking the time to blog about it. I'm not pregnant, and I'm not 100% sure when I will be pregnant again. Why do all this without a due date in sight? After breaking down and talking to my husband about it, I was able to reconfirm my true intentions.

1st- When I do see those two pink lines confirming that I am pregnant, I don't want to immediately feel dread thinking that I am going to relive my last birth experience. I don't want there to be any feelings of negativity or fear in sight. I want to feel happy, happy to be pregnant and happy because I know this time will be better no matter what. Even if I end up truly needing a cesarean section it will be better. Even if I have to be in the hospital again it will be better. It will be better because I took the time to prepare myself. This doesn't mean that my need to prepare will end once I am pregnant.
2nd- I want to get the word out on the high statistics of cesarean sections in the US, along with resources and support for those wishing to VBAC. I've been through one cesarean section and honestly I would love to help prevent an unnecessary one from happening to any woman out there. I know so many who have had unnecessary cesarean sections and I can't help but want to warn others of this is a major issue. I have also found that a lot of pregnant women out there were a lot like me and didn't know all their birthing options and rights. I didn't know anything about the effects of certain medical interventions and unfortunately these tend to lead to cesarean sections. Knowlegde=power and can ultimately lead to a better birth experience.

3rd- Preparing yourself for a birth experience takes a good amount of time. Just as finding a new home, purchasing a car or any other big life change, there is a lot of planning involved. The birth of your child can be the most life changing event, thus it should require even more careful thought and research. This includes researching ones birth options, interviewing care providers and deciding on ultimately where one wants to birth. Eating well and exercising to promote good health should be practiced before becoming pregnant so your body is more physically prepared. Another essential part is working past the previous experiences and conquering those fears that could inhibit a woman from being successful in her future birth. Some might be able to do all this in 9 months time and that is wonderful. I'm the type that likes to have things planned out far in advance because it gives me more peace of mind.

For those of you who are pregnant or not yet pregnant and wanting a VBAC here is a great resource from VBAC Facts that can help you on your way.

Top 8 Ways To Have An Unnecessary Cesarean Section

I loved this post from Nursing Birth, and I wanted to share it because one of my (and hopefully every woman's) main goals is to avoid an unnecessary c-section in the future. It originally started with 7 ways, but she added an 8th at the end. Most of the research that she cites in this post came from the book "The Thinking Woman's Guide to a Better Birth" by Henci Goer.

#7 Go the hospital in the early phases of labor.
Crawford is just plain right-on with this one! Too many obstetricians are quick to label a mom as having “dysfunctional labor” if she does not progress at least one centimeter an hour (for first time moms) or two centimeters and hour (for multiparous moms) immediately upon arriving to the hospital. I have even had some doctors I work with take a call from a mom at home that “sounds like she is in labor” and turn around and tell the residents to “start her on pit as soon as she gets here.” WHAT??!! Pam England, CNM, MA writes in her book Birthing From Within, “One advantage to laboring in the privacy of your home, with one-on-one midwifery support, is that should a problem arise that requires medical support at the hospital, you will not wonder whether your labor problems were caused by routine, unnecessary, or ill-timed hospital interventions.”

#6 Don’t eat or drink during a long labor.
Goer writes that dehydration and starvation caused by restricting food/drink intake during labor causes a woman not only considerable discomfort but can also lead to fever, prolonged labor, increased use of oxytocin (aka pitocin), instrumental delivery, and a non-reassuring fetal heart rate pattern/fetal distress. And what can all of these lead to…that’s right…a cesarean section! (Goer, 79-83)

#5 Get an amniotomy too soon.
Amniotomy (or artificially “breaking the bag of waters”) too soon can lead to umbilical cord compression/fetal distress, abnormal fetal heart rate patterns, cord prolapse (a surgical emergency where the umbilical cord slips out into the birth canal before the baby’s head), increased likelihood of maternal infection and hence a “race against the clock” to get a woman “delivered” before 24 hours is up, and lastly, a greater chance that the baby get “stuck” in a posterior (back of head toward your back) or acynclitic (head tilted off to one side) position which can stall labor and make pushing at best, difficult and at worse, unsuccessful. Bottom line, if it ain’t broke, leave it alone! Not obeying that rule could lead you to an unnecessary cesarean! (Goer, 99-104)

#4 Accept pitocin to induce or stimulate contractions.
The use of oxytocin (pitocin) for labor augmentation (aka “revving up a slow labor”) or induction (aka artificially starting a labor that hasn’t started on its own) has its own risks. Although oxytocin is quite effective at stimulating contractions, it often makes contractions stronger and longer than natural contractions, can cause too many contractions too close together (aka uterine tachysystole or hyperstimulation) which can lead to fetal distress, can double the chances of a baby being born in poor condition, and eventually can lead you to the operating room! (Goer, 65)

#3 Request an epidural.
Research has shown that epidurals 1) interfere with a mother’s natural release of labor hormones which can in turn (among other things) slow or stop her progress of labor, 2) increase her chances of needing pitocin augmentation for said slowed labor, 3) numb her pelvic floor muscles, which are important in guiding her baby’s head into a good position for birth , 4) can cause maternal fever than can be mistaken as a sign of infection, 5) can cause a significant drop in her blood pressure which can interfere with how much blood supply is getting to the baby and can lead to profoundly negative effects on the baby’s heart rate, 6) significantly impair in her ability to push her baby out effectively. All of these side effects/risks, as research has shown can, and often does, lead to a cesarean section. (See “Epidurals: risks and concerns for mother and baby” by Dr Sarah J. Buckley)

#2 Accept hospital staff’s comments on lack of progress without challenge.
In my opinion, nothing is more detrimental to a woman’s labor progress and ultimately her birth experience than negativity in the labor room from labor & birth attendants, especially the people who are the “professionals” like obstetricians, midwives, and nurses. As Marsden Wagner, MD, MS writes in his book Born in the USA, fear and anxiety stop labor. And giving a woman the impression that she is “failing” can lead to a helpless and hopeless attitude and eventually a cascade of interventions that might very well lead to a cesarean section.

#1 Just ask!
Believe it or not, there are some OBGYNs out there that will agree to perform a cesarean section on a first time mom without medical indication. Goer writes, “Popping up lately in the medical literature are arguments that women should be able to have first cesareans for the asking as well. Again, this is presented as a freedom of choice issue. But how much real freedom do women have in a culture that portrays labor as torture and C-sections as a ‘no muss, no fuss’ option?” Goer states that the obstetric belief that choosing between a cesarean and vaginal birth is like choosing “between chocolate and vanilla” is really about six things: money, impatience, convenience, peer pressure, hospital culture, and defensive medicine. What I find even more disturbing than this, however, is that women who do desire to avoid a cesarean and plan for a vaginal birth after a cesarean (VBAC) are finding themselves with less choice and opportunity to do so in more and more communities around this country as more and more obstetricians are refusing to attend VBACs and hospitals are either banning or placing de facto bans on VBACs.

And lastly here is my own addition…number 8!

#8 Agree to a labor induction without medical indication.
Induction of labor comes with risks and the BIGGEST risk is the risk of cesarean section. When induction of labor is done for a medical reason, either related to mom or baby, and the risks of continuing the pregnancy are greater than the risks of induction, then this is the only time when labor induction is appropriate and warranted. But when a woman agrees to a labor induction without any medical reason, then she is putting herself at risk for an unnecessary cesarean section, plain and simple.
Many obstetricians I work with claim that all the “elective” labor inductions (that is, inductions without medical indication) are because the woman “demands” it. And don’t get me wrong, there are some women out there who are a bit mislead. But all to often a woman shows up for a labor induction and it is overwhelmingly obvious that she: 1) wasn’t fully explained both the benefits AND risks of labor induction, 2) wasn’t told that labor induction can take up to three days to complete, 3) wasn’t told that comfort measures like using a jacuzzi tub or shower, walking, using the birthing ball, eating, drinking, and general freedom of movement are MAJORLY restricted during labor induction either because of hospital policy, obstetrician’s philosophy, or the requirement of continuous external fetal monitoring, 4) didn’t realize she had the option to say NO.

So there you have it, the Top 8 ways to have an unnecessary cesarean section. I wish it wasn’t true but unfortunately it IS!

In closing I would like to leave you with one of my favorite quotes:

“We have a secret in our culture, and it’s not that birth is painful; it’s that women are strong.” ~ Laura Stavoe Harm