Summer Letter 2014

Delivering Baby

Recently, one of our young hospital aides confided that her biggest fear is to deliver her baby vaginally. She plans to beg her obstetrician for a Cesarean. I tried to educate her that a C-section isn’t an easy shortcut. While it is at times necessary and can be lifesaving, Cesarean is a major surgery and increases risk for complications. I know her doctor will counsel her as well.

In fact, there’s a move underway to reduce the rate of unnecessary C-sections in the United States. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine (ACOG/SMFM) have released new guidelines recommending physicians allow women more time to push during early and active phases of labor. Evidence shows overall that labor moves along more slowly than once believed, and mothers may simply need more time to labor and deliver vaginally.

The rate of C-sections in this country is soaring. One in every three women delivers by C-section according to the Centers for Disease Control and Prevention. Once a woman has a Cesarean, there’s a good chance she will deliver future babies surgically.

To reduce the chances for a C-section, there are steps women can take. For example, staying fit, avoiding excessive weight gain and knowing your doctor’s and hospital’s C-section rate can lower the risk. Recently, Consumer Reports ranked hospitals according to their frequency for C-sections for low-risk pregnancies. Not requesting an induction for labor unless there’s a medical reason – or hiring a doula – can help. Research shows women who have continuous support from a trained assistant are more likely to deliver vaginally.

In some cases, a C-section is the best way to deliver for mother and baby. But, as I told our young aide, if a woman has had a low-risk pregnancy and baby is in a head-down position, striving for a vaginal birth is generally less risky and recovery is almost always much easier.

As a labor and delivery nurse, I welcome ACOG and SMFM’s new guidelines to prevent unnecessary Cesareans and Consumer Reports’ ranking of hospitals. And, I hope my colleague considers the evidence carefully when it's time to deliver her baby.

Best Wishes,

Linda Ciampa, RN