Must Birth Be By Cesarean?

Each person’s experience and medical needs are individual.

You may be told that a cesarean or a vaginal birth is the safest option for you. While for most people a vaginal birth is safest, an individual is not “most people.” Because each of our body’s needs are individual the ultimate responsibility is on ourselves.

Some of the parents coming to our website are especially determined to have a vaginal birth. When the determination to avoid a cesarean is high, it’s normal to question whether advice for a cesarean is relative or absolute.

Give yourself permission to see if your expectations and desires match the medical needs of you and/or your baby. Today, the accepted reasons for a surgical birth are so common that it can be a challenge for parents to discern where the recommendation falls between recommended or absolutely medically necessary.

Your doctor will have a conversation about the risks and benefits of a cesarean. This is the “informed consent” conversation. Look below for tips to your portion of the discussion in case you want more information during this vital conversation.

The most important variant in accepting a cesarean that may not be absolutely medically necessary is you. Sometimes accepting a surgical birth is practical even if a vaginal birth may be possible. It’s not the place of Spinning Babies® to decide. If you want advice you might seek the support of professionals and activist who share statistics. I write for your reflection, not for statistical likelihood. Others do that job and I refer you to their up-to-date info. (Childbirthconnection.org, Evidence-basedbirth.org)

When challenged by the recommendation of a cesarean, keep the conversation open between you and your provider. Closing down, a coping technique to reduce stress, is actually disempowering. So is out and out resistance. Rather seek to engage a conversation as equals with the understanding you are both seeking the choice that protects you and your baby. The strategies are different but the goal is the same.

To keep the conversation open, add a third element. The need that has arrised. Let’s say the need is the baby’s breech position needs more skillful care for birth than a head down baby. In the birth setting you chose or you find yourself in, the skill in a safe cesarean may be higher than the skill of the doctor for a vaginal breech birth. The risk is seen as higher than a head down baby’s vaginal birth and experience with vaginal breech birth is scant. A cesarean is offered as a solution.  You have needs to know your baby is ready to be born or has benefits of labor. You express that. Perhaps a mutual solution is to do the cesarean when labor begins.

In some settings, like rural hospitals, this may not be practical. You may accept the cesarean at a later gestation or you may decide to travel. The solutions you choose are more appropriately chosen when you are aware of your needs and to be honest, the needs of your provider. It’s not wise to push a provider into a situation where they are unable to meet your needs. 

The dialogue between equals who hold each other in high regard can discover needs and find creative solutions to meet the need or compromise.