C-sections: Are They Necessary for Every 1 in 4 Women in the UK?

An overwhelming majority of people I meet who have had c-sections are so grateful that they were able to get their baby out safely. They say that if it weren’t for them, they might be dead or their baby might be dead. However, according to the World Health Organisation (WHO), caesarean sections should only be performed when medically necessary – no more than about 10%-15% of all births. So what about the 10% of women who are still getting c-sections in the UK, but they aren’t medically necessary? Why does it seem like the c-section rate is growing still? Women are still getting unnecessary c-sections and I think it’s due to lack of knowledge and preparation. Doctors tell every c-section patient that it was medically necessary, but that’s not what the statistics show.

Unfortunately, the doctors tell c-section patients a reason to justify the need for the c-section. I’m going to list a couple of common reasons given for c-sections and why they are not valid reasons for this major abdominal surgery. 

1. The cord was wrapped around my baby. This is the most common reason I hear, read and know about given to women who ended up with a c-section. They find that when the baby is out, the umbilical cord is wrapped around baby’s neck (nuchal cord) or body, and they believe that’s why the baby wasn’t coming out (failure to progress, FTP), or why the baby’s heart rate was dropping during contractions or second stage (fetal distress). It is the most common because 1 in 3 babies are naturally born with the cord wrapped around them! According to this 2012 study on umbilical cord lengths and outcomes, short umbilical cords often lead to an increased rate of c-sections, but with no significant negative outcome. Longer umbilical cords were more often wrapped around the baby, but also with no significant rise of negative outcomes. The presence of a nuchal cord (cord wrapped around neck) isn’t a cause for concern because babies get oxygen through their UMBILICAL CORD prior to and during birth (not the neck)!

Also note that even though some umbilical cords are shorter, they don’t hold back the baby from coming out! This article by a midwife explains that not just the baby is descending, but the whole package–amniotic sack, placenta, umbilical cord, and baby–descends together. The umbilical cord cannot prevent a baby from coming out of the womb.

“Research has found that a nuchal cord is not associated with morbidity or mortality for the baby during pregnancy (Carey & Rayburn 2000; Aksoy 2003; Clapp III et al. 2003; Gonzalez-Quintero et al. 2004). Unfortunately some babies die before labour begins, and there is often no known reason which can add to the devastation. When these babies are born they are often found to have the cord around their neck (like a 3rd of all babies).”

“During labour a nuchal cord does not cause a problem. There is no indication to undergo a c-section if a nuchal cord is identified antenatally (RCOG 2009).”

To find more info about nuchal cords, read this.

2. My baby was too big to fit through my pelvis. These mothers will tell you how much their baby weighed at birth and if it’s in the category of a “big baby,” the obvious reason for having a c-section is because “there was no way that baby was going to fit through your pelvis.”

Conceiving, growing and birthing a baby is an amazing miracle of life. It all runs parallel to nature and what is natural. It would be quite opposed to the evolutionary theory if suddenly in our generation, women were growing babies inside their body that would be too big to fit through the birth canal! There are some extreme cases of gestational diabetes and women who generally overload on eating; however, average women naturally grow average-sized babies that they can birth. The some U.S. doctors define a “big baby” as any baby born over 8lb 13oz, and others 9lb 15oz. Either way, we come upon a great error–believing that EVERY baby should be under 8lb 13oz OR ELSE they won’t be able to fit through the birth canal.

The obvious answer to this is that some women are larger and others are smaller. Larger women (meaning women with wider birth canals) can birth larger babies because they’re carrying babies with their genes. Sometimes a small woman bearing the baby of a very large/tall man will spontaneously go into labour sooner than 40 weeks (since if they went to 40 weeks, they may be too big to birth). They go into spontaneous labour sooner because the baby instinctually knows when its ready to come out. There is a chemical communication between mother and baby and nature takes its course.

If you’re still doubtful, check out this birth story where a midwife almost couldn’t believe that a mother was going to be able to fit a baby through her birth canal. Ultimately, once you have intervention, you won’t really be able to know if you could have birthed your baby naturally.

3. My body failed to progress. This is one of my biggest pet peeves. Midwives and doctors expect your birth to go according to their schedule. Well, the baby doesn’t know what time it is! Your body will open up–whether it’ll take 4 hours or 40 hours. There’s something called the Natural Alignment Plateau (N.A.P.) that I teach in my Bradley classes that explains that it’s normal for a mother to go through a period of time where dilation doesn’t seem to be progressing. There are several natural, healthy and normal reasons for this. It may have to do with baby’s positioning or mother needs rest, but it is something that if a mother knows is normal ahead of time, they can avoid being pressured into induction or c-section.

A recent study from 2013 showed that “The most common indications for primary cesarean delivery were failure to progress (35.4%).” This means that more than 1 out of 3 women were sectioned due to this reason.

Among women with failure to progress, 42.6% of primiparous women and 33.5% of multiparous women never progressed beyond 5 cm of dilation before delivery. Among women who reached the second stage of labor, 17.3% underwent cesarean delivery for arrest of descent before 2 hours and only 1.1% were given a trial of operative vaginal delivery. (Boyle, Reddy et al. 2013).

I’ve heard many doctors say, “Look, you’ve been labouring for ___ hours, it’s time for the baby to come out. Let’s give you some <drug> to speed up the process,” even worse other doctors will say, “We need to get this baby out now–we’re prepping you for a c-section.” There is NO NEED to rush the baby out; these kinds of interferences just cause more problems later, whether baby gets drugged, you have trouble bonding with baby later, or your recovery is much more painful than it would be if you had a natural birth.

4. My baby was breech. Breech babies are very uncommon. Only 4% of babies do not turn head down at the time of birth. The main problem we’re seeing starts with the confusion of the “due date,” (see this post of the Problem with Due Dates“) and not allowing women to wait for their babies to turn before intervening. In this article, it states that 18.5% of c-sections were due to “fetal malpresentation.” A breech baby can be breech for perfectly natural reasons. Since gravity pulls the heaviest part of the baby downwards (usually the head), it allows for the biggest/heaviest part of the baby to pass through the birth canal first, making the rest of the body easier to come through. Some babies’ bottoms may just be bigger/heavier than their heads! Check out this amazing breech birth video that shows you how a woman can safely birth a breech baby with a trained midwife/doctor.

The problem we see is that women are told their baby is breech before their 40-week “due date” and that they need to intervene with a c-section. Many of these women, if they just waited, would have been able to have a natural vaginal delivery because their babies would have turned. However, mothers don’t want to hear that they had an unnecessary c-section, so doctors just tell them that it was safer for them and the baby to have a c-section than to wait.

5. I was told I can’t birth twins vaginally. Is there a risk to having twins vaginally? This mainly depends on positioning, but once again, the position of the babies doesn’t necessarily mean there’s something wrong with the baby or even the mother. The position may be what is optimal for them to come out of the womb; however, it’s the doctors who have less knowledge about birthing breech babies or multiples vaginally, so they feel safer and more comfortable doing a c-section. You CAN birth twins vaginally. Even triplets can be born vaginally without medication (read this triplet birth story here). There has been an increase of preterm twin births along with an increase of intensive pregnancy management for women pregnant with multiples. (Kogan, etc, 2000). With close monitoring and interventions, baby’s lives are left in the hands of doctors and their machines.

6. My body wasn’t strong enough to push out my baby. This happens more often than we realise. Mothers go to the hospital too soon, end up not being able to walk around, eat, rest, shower because they are being bothered constantly to be monitored, get too exhausted and by second stage, they’re so tired they can’t push! Sometimes, doctors are able to use vacuum-extraction. Other times, forceps are used, but more than 1 out of every 4 mothers are getting cesarean sections. There may be many reasons to get a c-section, and sometimes it is necessary; however, it is likely that 1 out of every 4 mothers NEED a c-section?

This is where mothers need to learn. They need to learn much more about birth than what they learn in hospital antenatal classes. They need to learn what’s B.E.S.T.–Bradley Energy-Saving Techniques. They need to be able to identify the different stages of labour, what transition is, and be practicing relaxation techniques to get them through contractions. Your body is strong enough, you just need the energy left for second stage pushing! Don’t let anyone make you believe you didn’t have the physical strength in you. You just needed to prepare for the marathon of birth–stamina, stamina, stamina.

**Disclaimer**: C-sections are excellent advances in technology that allow us to save lives–both mother and baby. This list is meant to help encourage mothers who do not want to have a c-section. This is not meant to shame mothers who had a c-section.  My goal is for mothers to make the best informed decisions possible. I hope this list was informative rather than offensive. If you are adamant about avoiding a c-section, please consider taking natural childbirth classes. You will be armed with knowledge and prepared with daily exercises to give you peace of mind to have a calm birth.

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