How to avoid a c-section/intervention?

[rainand]

Hi,

I'm 25 weeks (so I'm still a bit early) but I really don't want to have a c-section or any intervention, and I'm really really keen on having a natural birth. I live away from my family so I'm even more keen on going it natural. It is my 1st baby.

I'm just wondering whether there is anything I can start doing from now to ensure that I have a natural birth? My pregnancy is thankfully normal, and I am hoping to work until possibly 34-36 weeks (haven't decided on final details yet). I wouldn't say I am awfully active - I don't take part in any yoga/pilates classes (a bit pricey) but could do if it came highly recommended.

Any tips folks? Was there anything you did that you thing helped you to give birth naturally and avoid a c-section?

Thanks! :)

[PseudoBadger]

Absolutely agree that even with the best will in the world, it may just have to happen. It probably won't, but please don't be upset if it does. I got induced for PE, coped so well with the drip, got fully dilated, pushed for over 2 hours and the little limpet didn't budge. So out he came through the sun roof!

[GiveMeVegemite]

I know lots of mums, me included, that would have avoided interventions and a c section, but I ended up getting induced and had an emergency section anyway. There is nothing you can do to avoid it, if you have fetal distress then they will need to get the baby out as fast as possible and there is nothing you can do to avoid it. Sorry! I did Pilates but they obviously didn't help....

[Stixswhichtwizzle]

At no point did I labour on a bed either. Don't build up your 'ideal birth'. Think about what you'd like by all means but be prepared to go with the flow. That helped me come to terms with my birth experience.

[Stixswhichtwizzle]

There's not much you can do. I felt same way as you whilst pregnant. My labour went well. Laboured in pool until 7 cm when MW noticed thick meconium in waters. She checked HB which had been fine and it was suddenly dropping. I was whisked off to consultant led delivery ward. Given an EPI whilst they took blood from DD head (whilst inside me) to check oxygen levels following results an EMCS was done so quickly the EPI didn't have time to work and it was done under a general. The CS saved my DD life. The cord was wrapped round her arm in such a way she couldn't descend any further.

You can't plan for these things. I tried lots of the thing you're suggesting to no avail. However, up until EMCS I laboured for 15 hrs (active) with water and gas and air do perhaps something did help prepare me...

[rainand]

Thank you ladies for all the advice, I'm taking it on board :)

[afterdinnerkiss]

eat lots, relax and squat.

i would say relax as much as possible, here in women are discouraged from working in the 6 weeks up to the birth, sent on statutory leave to rest (mentally and physically) and prepare for the birth, as it is believed that this rest period improves birth outcomes - women facing stress during and at the end of pregnancy may experience less easy birthing experiences.

i would say the number one skill is learning to squat - practice it every day for as long as possible - not squatting up and down which is tough on the knees but staying seated for longer periods in the squatting position. I read Ina May Gaskins guide to birth religiously as i am terrified of medical interventions that can be avoided. the book is great and will give you a hundred answers to your questions.

anyway, back to squatting : you are less likely to need a CS if you stay upright and keep moving your hips. squatting, in the later stages is even better. lying flat in bed the whole time a la mistresses of Louis XIV will dramatically increase the likelihood of a CS, as will an epidural (if it can be avoided). whilst people in other (poorer) cultures, e.g. rural south america and india can sit very comfortably on the floor, our muscles have been trained out of it and we can only sit comfortably on chairs. not good for childbirth!!

[AmberLav]

Oh, and putting on less than a stone in weight?! I put on 20lbs, so a stone and a half, and that was lost immediately when I delivered (was back to my pre-pregnancy weight by the time I got home from hospital 2 days later).

Putting on anything less than I did would have caused me to lose weight!

Off the original topic a bit, but I suppose it is covered by don't follow any advice rigorously, take everything with a pinch of salt!

Good luck

[AmberLav]

Think positively, but be prepared for all outcomes! That is the best thing to do!

I had a succession of friends with back to back babies not long before I gave birth, so I did the online exercises to encourage best positioning.

I ate lots of iron-rich foods, as I'd noticed a link between low iron levels and blood loss (but I think I do have naturally high iron levels, so I appreciate other ladies have a lot of trouble keeping up iron levels despite great diets).

What I wish I'd done:

• tried perineal massage ( I had a 3rd degree tear). Probably wouldn't have done anything as DS was 9lbs 12ozs, but at least I'd have tried... (I'm trying that this time round)
  
• eaten and drunk more in early labour as there is a possibility that my contractions showed because I was running out of food energy (long labour!)
  
• stayed more upright in the pool (not that I'm planning on using the pool this time as that may also have slowed contractions...)

[MaMaPo]

I agree with a lot of these posts. I had an EMCS after doing pilates and yoga, keeping fit, putting on not too much weight, practicing breathing techniques etc - none of these things could stop my daughter from getting her head into an impossible position for birth, or could stop my (usually very low) blood pressure from skyrocketing at 38 weeks leading to a decision to induce.

However, I think my overall health helped a lot with my recovery - I was extremely active, out daily and for long stretches, from about 10 days post-birth, and have lost all (and more) of the baby weight.

So try what you'd like to stay fit and healthy, learn and practice some breathing/hypnobirthing techniques, then enter the process of childbirth with an open mind, because there is a hell of a lot going on over which you have no control at all. The best outcome is healthy mum and healthy baby - they don't give out medals for anything else!

Congratulations on your pregnancy and best of luck!

[amyboo]

I don't think there's anything you can do to "avoid" certain things. I've had two pregnancies - 1 was an ELCS as DS was firmly footling breech the whole way through. He couldn't be turned (we tried) and was essentially stuck, so I had no real option. Second one was an induction, as DS2 died in utero at 36 weeks, so again I had no real option.

Am currently on my 3rd pregnancy (30 weeks), and despite being healthy, not putting on much weight, with good core strength etc, I will be heading for another induction, as I had random bleeding at 16 weeks and have been on blood thinning medication since then which will need to be stopped before I can give birth. I may also be heading for another ELCS, as my placenta is quite low and at last check was partially blocking my cervix

So, I guess what I'm saying is, don't get too obsessed about having the "perfect" birth. The perfect birth, imo, is getting to the end with a sfae, healthy baby and a safe, healthy you. I was devastated when I found out DS1 would be a ELCS as I felt I'd failed somehow. But, in the grand scheme of things it really mattered not a jot.

[rainand]

BobbiFleckmann, I read Gowri Motha's book at the beginning of my pregnancy and though I was very keen to follow her regime, I just couldn't do it. It is on my book shelf and I will re-read it.

I haven't put any weight on the rest of my body but my breasts are now huge and of course so is my stomach. I haven't been weighed at the midwife appointments (I should probably request that).

[BobbiFleckmann]

The main reason for the high level of intervention in western hospitals given by Gowri Motha (can you see a theme developing in my threads?!) is that western women sit back and eat for two and get too fat - they're not in peak fitness for labouring. Her view is you shouldn't gain more than a stone in total (& most of that will be baby / water / blood) and the only time you need more calories is in teh last few weeks and it's only 200c / day extra or something. You wouldn't sit on a sofa for nine months before running a marathon etc.

[Missingthemincepies]

Agree with everything said already. Focus on healthy mum and healthy baby, doesn't matter how much help you need achieving that, it's what everyone's there for.
As for your options:
A) yes I would. Good for core strength, encourages pelvic floor maintained w, and get to meet other expectant mums in your situation.
B) no. Massive fan of natal hypnotherapy, but you can buy the CD for £12 and the book for under a tenner. IMHO having done both course and cd, you really don't need the course.
C) depends on the support you expect from your DH. I've no experience of having a doula present but would be put off if I had a supportive DH who had read well about birth and what to expect, knew what choices I would make and who would feel sidelined by the presence of someone else in the room.
D) I'd never have a home birth. And that's after a very straightforward 5.5 hour labour without intervention. Lots of threads discussing pros and cons, but you need to do the research and choose what suits you.

Keep generally as active as you can. Sleep lots in last few weeks. Do things to make you happy (dinner out, meet with friends etc) and try to come round to the "what will be will be" type attitude. There are some things you just can't change. Good luck!

[Fairylea]

I would save your money, just keep active... eat well and read up on hynpobirth if it helps you to feel more in control. I know some people swear by it but it doesn't work for everyone (my sil did a course and was apparently shouting "just give me a fucking epidural" every 3minutes all the way to the hospital - this was her second baby).

Most of the complications that require a section cannot be prepared for or avoided - baby in an awkward position, long labour leading to mum and baby getting tired anddistressed, placenta problems, breech complications... the list goes on. It really is pot luck!

There is some evidence that there is a cascade of intervention - ie if you have an epidural statistically you may be more likely to end up having an assisted birth. But again anything is possible. And an epidural is a life saver for many.

If you need pain relief, ask for it. We are.lucky to live in a country where we can have it.

[BobbiFleckmann]

by the way Gowri Motha does a hypnobirthing CD - i did the classes as well but the CD is good if you don't want to pay £££ for a course. Some reflexology is brilliant and yoga / pilates you can do every day at home if you know how.

Natural birth isn't the be-all though - the drugs are bloody brilliant and anaesthetists are giants amongst (wo)men.

[HandbagCrab]

You need to do what you think is best for you I'm afraid. I don't know of any study that could tell you that pregnancy yoga results in a 10% reduction in c-sections or likewise for anything else you have mentioned.

There's lots of talk of maternal fear being a cause of intervention. Maybe focus on the aspects of planning that make you feel empowered and calm.

[BobbiFleckmann]

Read Gowri Motha's "The Gentle Birth Method" and follow it religiously. you're quite late to be starting it but are you quite fit already? that said, i followed it (save for going sugar free) and still had a c-sec - some things you can't help - but i was fit as a fiddle before and thinnest i've ever been within a month (boo hoo)

[Angelico]

Personally I would spend the money on the yoga or pilates and maybe get a hypnobirthing CD. I say this as someone who had an ELCS. There's an excellent CS book by Leigh East which ironically has a chapter all about avoiding a CS so it's worth a read. And YY to what others are saying - the book mentions that PND is much higher amongst women who are 'disappointed' by their birth experience. I really think this is one of those things that gets blown out of all proportion on MN. I don't know anyone in RL who is 'disappointed' over how their baby got out, they were just relieved they arrived safely.

And my ELCS meant I was separated from DD for about 40 mins after her birth which I fretted about beforehand. It did neither of us any harm, unsurprisingly and gave her some nice time with her dad. I was also able to BF immediately in spite of CS if that is important to you.

[tomatoplantproject]

Don't have a breech baby.

[phoenixrose314]

Cannot emphasise more what the others have said - I have yet to have a baby myself (am currently 35+3) but have a family history of PND, and because I am keen to avoid carrying on that particular family tradition, have researched a lot about it. There is an astounding amount of current research to suggest that we as expectant mothers put far too much pressure on ourselves to be a certain type of mum, to have a natural birth, to breast feed, etc. and then when it doesn't happen we feel like failures - although we are not.

Like you, I would prefer a natural birth and have tried to stay active walking the dog, swimming etc. and hoping that baby stays in a good position so I can have the birthing pool in my local maternity unit. However, if it comes to an EMCS or forceps or any kind of necessary intervention, I will have to swallow my own pride and love that birth for what it is - the safe arrival of my lovely boy or girl. It is the only birth they will ever have, and it's worth treasuring no matter what.

FWIW, my mum's PND was triggered by my sister being born prem and my mum was asleep for the birth. They never bonded until DSis was much older. But it was her own expectations of herself as a parent that held her back.

[YouOldSlag]

There are no guarantees.

[rainand]

Thank you everyone! :) I understand that a c-section/intervention can't be avoided and I am open to the idea of having one (I suppose I do need to plan what would happen if I did have a c-section - I will look into that) but I think my question really is, will the following make my chances of having a c-section any less? I am on a tight budget generally but of course the health of myself and baby comes first:

a) Join a yoga/pilates class (pay £10 per hour) per week
b) Go on a hypnobirthing course (£300)
c) Get a doula (£300 - £400) - DH is not too keen on this
d) Opt for a home birth (3 min drive to hospital) - DH is not too keen on this either

DH can be convinced of course :) but I need to decide what I think would be the best for me!

[newgirl]

Im with others. I was fit, ate well, did yoga etc but my first baby was in a funny position and towards the end of my labour needed to come out by csection.

Do all you can to stay fit and active and well - get great advice from nct, doula etc and please dont give yourself a hard time if it doesn't work out - but of course it probably will!

Mine are now grown up and that day of childbirth was a mere pinprick in the years of being a parent!

[CareerGirl01]

Agree with all the mums here - if you have certain expectations you might end up with a higher chance of PND. You'll have enough to cope with when you have a new baby - let alone feeling bad about how you gave birth!