The Cesarean Epidemic

In continuing to discuss VBAC in honor of Cesarean Awareness Month (CAM), I was planning to write about skyrocketing cesarean rates. In my life before kids, I worked in public health, and I always get a little excited when I can merge my two worlds. So, I’ve been mulling this over, but someone else beat me to it, and since her writing is way more eloquent than mine, I’m just going to point you to her blog:

If you haven’t checked out Kmom’s blog and website, you should. My friends and family tease me about my love of reading and reciting research, but I’ve got nothing on Kmom.

Of course, I do need to offer my own commentary as well. Here’s what I want to explore-how do we fix this? When I first started working in the birth world, I thought I could rescue women. I thought if only every woman could have a smart doula who could empower her with lots of information and defend her against her doctor, we could solve the problem. But as I’ve said before, it’s just not so.

How do we help women to find their power? Trust themselves? Ask questions?

How do we help care providers to be more compassionate? Take more time with women? Practice evidence-based medicine? Stop basing standard of care on time and liability?

I’d love to hear your thoughts on this. And I’ll share mine soon.



About Brielle

I am a Licensed Midwife and doula/monitrice in Austin, TX and a very happy homeschooling mama to my two amazing children.
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2 Responses to The Cesarean Epidemic

  1. Melek says:

    First of all, I LOVE Kmom. She is so amazing. Have you seen the breakdown she does on VBA2C research? It is really, really good and if I were going to research (which I’m NOT!) I would bookmark that page and reread it a million times before my next birth.

    I think an important place to start would be to get an idea of what kind of birth a woman wants. If she wants a natural birth, does she know what it will take on her end to get this? As I learned, it is more than just saying you want one–it takes a lot of work and the willingness to take personal responsibility for so much in your pregnancy. If we know a woman wants a certain type of birth, we can give her a lot of the knowledge and resources necessary to make this happen. For example, if she doesn’t even know, or think to ask, what her doctor’s policy is on going post-dates, she may be staring down the barrel of an induction around 40 weeks when she never even thought of that when she chose her care provider.

    I think also erasing, or at least trying to address, a lot of the fear around childbirth and the unknown would be really helpful. So often a woman’s only information about childbirth may come from mainstream media or people who are all too happy to talk about how painful the experience is and create a lot of fear and anxiety around the whole thing. This can lead to a woman accepting all kinds of interventions she might not otherwise want for fear of not being able to handle the pain of labor. I’m not saying every woman should have to go all natural, but I do think it is important that women are informed on the risks and benefits on all procedures associated with the birth they desire.

    As far as care providers, I think it would do a lot of good if doctors (and midwives) would be really up front with what their practice is comfortable handling. It would be great if they would spell out their policy on going post-dates, when they would consider inducing a woman (whether she asks or they feel it is time and how difficult would it be for a woman to refuse), a woman’s ability to refuse routine prenatal testing and/or ultrasounds. As far as VBACs specifically, I think the post-dates issue is especially important, as well as if they would induce (and how). That can really be important information for a VBAC mom to have. And, of course, you don’t want to have a mom get to the end of her pregnancy and have a VBAC mom, who thought everything was proceeding well and normally, all of a sudden be on a timetable to have her baby. I think if a CP is going to have a policy, that’s fine, but I think they should also be willing and able to explain the rationale behind it, have that be supported by scientific evidence, and be open and honest with their patients so that no one is blindsided.

  2. Keep this going please, great job!

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