Once A C-Section, Always A C-Section--NOT!

It was in the old days (circa 1979). The residents at Charity Hospital had been notified that all but the most crucial of power sources would be out while Maintenance did some electrical work. We had been delivering babies by flashlight, the better lighting reserved for surgical suites. We were good, well-trained--starting IVs by feel, running Labor and Delivery in the shadows without missing a beat. Childbirth went on in the non-air conditioned, unlit labyrinth of the 10th floor of that great grey building on Tulane Avenue. Now try to imagine, if you will, the tense scene that day.

I sat in the delivery room, waiting. My patient was completely dilated and pushing, her baby moments away from breathing room air instead of umbilical cord exchange. I prayed, though, that it would be that simple, for the patient had had a C-section two years earlier. She had arrived unannounced, with no prenatal care, ready to deliver. There was no time to prepare for a repeat C-section. "Once a C-section, always a C-section," played through my head according to my training. I feared the force of expulsion that normally results in a delivery would tear the old scar in her womb (uterus), creating a hemorrhagic crisis for baby and mother. "Please don't rupture," I prayed. The nurse bit her lip as I uttered the words. It was melodramatic to say the least.

It was so silly, as it turned out.

At that time, soon-to-be published studies would confirm earlier research that concluded that vaginal birth after cesarean (VBAC) was no more risky than any vaginal delivery. It's funny how times have changed.

Enter capitalism.

Looking to lower hospital costs for maternity services, managed care--HMOs, PPOs, and several other letter combinations-- welcomed the fortuitous results of the data, validating their push to lower C- section rates. The first immediate tier of the rate that could fall was the repeat C-section rate. VBAC was here to stay. Now openly encouraged, a specialist from twenty years ago would wonder if we were out of our minds. And now there are studies investigating vaginal delivery after more than one or two C-sections.

If you listen carefully, you can hear the squirming of even the most holistic of yesteryear's midwives.

Even with the overwhelming evidence exonerating VBAC as completely safe, many patients still choose, even insist upon, repeat C-section. They fear a long fruitless labor, only to resort to surgical delivery anyway. They may want a scheduled birth, instead of the uncertainty of the onset of labor, which may not come for weeks after a scheduled C-section. They may fear that an uneventful C-section recovery may be easier than recuperating from a very difficult vaginal delivery. These are real concerns, and even though I encourage and favor VBAC, I still feel it should be the patient's decision. As long as she realizes that the infection and transfusion rate is ten times greate...

When you're pregnant, the moment you look forward to and dread the most is giving birth. It's an amazing experience to bring your baby into the world, but you also have concerns. For instance, if this is your first baby, you may be concerned about the labor itself, and you may be wondering what it will be like.

Alternative Birthing Experiences

You may be considering alternative birth options like having a home delivery or a water birth . It's best to talk all of your options over with your doctor and find a birth plan that you're comfortable with so that everyone is fully prepared for the big day.

Dealing With The Pain

One of the best ways to cope with the pain of childbirth is to prepare yourself prior to your delivery date by becoming informed about your many options for pain relief.  Many women debate the option about whether or not to receive epidural pain relief . However, if this is not the right pain treatment option for you and if you are considering trying to experience the birth of your child naturally, then you may want to look into signing up for lamaze classes so that you can learn to relax and breath your way through the pain.  It is also a good idea to study up on all of the latest and greatest pain medications and alternatives available so that if your labor pain eventually becomes too much to experience natural childbirth , you will know which pain relief is right for you and your baby.  Get all of  the information for understanding epidurals and about what an epidural is.  Also find out about other pain relief options like the Bradley Childbirth method , pitocin , and other alternatives to epidurals .  The more your prepare yourself prior to the big day, the better equipped you will be to make the right decision for the immediate situation.

Birthing Complications

But as you approach delivery day, your biggest concerns may have to do with delivery complications: what are the chances that ther...