It is also a month where roughly 25% of first time mothers in our area will deliver their babies via cesarean section.
That means 1 in 4 women will have a major surgery instead of a vaginal birth.
Let me start off by saying that cesarean sections are not evil. They serve a purpose, they save lives and they have a place in our world. However, the WHO (World Health Organization) states that the best outcomes for women and babies appear to occur with cesarean section rates of 5% to 10%. Rates above 15% seem to do more harm than good. (Althabe and Belizan 2006).
What gives Northern Virginia? Where do we get that extra 10%?
In my opinion we get that extra 10% when we practice fear mongering among a vulnerable population (mothers) instead of evidenced based medicine.
We get the extra 10% by telling tiny moms that they can’t deliver big babies. Even though the definition of fetal macrosomia is a “baby weighing more than 8 pounds 13 oz at birth” and occurs in only 9% of births, with risks associate with vaginal delivery only increasing when the baby is 9 pounds 14 oz or bigger. Even though we know that predictions of a baby’s birth weight tend to be inaccurate, with a variation of 11.6 to 19.4 oz of error.
We get the extra 10% by putting laboring mothers on a time clock and telling them that they are not progressing quickly enough. This is a great article that explains Freidman’s Curve and the results of it’s use better than I ever could. Basically, we are putting women on a curve to predict progression of labor that has been proven to be inaccurate since its conception in 1955. Unlike in 1955, when active labor began to progress more rapidly at 3cm (96% of the studied births were medicated in some way) in 2014 active labor is seen to start progressing rapidly on its own at 6cm. In the article I linked above 4 in 10 cesarean sections were performed at 5cm, citing “failure to progress”.
I urge pregnant moms and their partners to prepare for labor to be a slow and steady progression towards birth, rather than the predictable timed race we are taught to expect.
I will explore some more reasons for cesarean birth and some of the short term and lasting complications for mother and baby as April progresses. I will share my own experience with cesarean birth and my subsequent VBAC (Vaginal Birth After Cesarean). Hopefully we will all learn something this month!
For today I will leave you with this thought: For some moms a cesarean is no big deal, but for some moms it is a crushing blow. Please do not minimize that mama’s emotions with the use of the popular phrase “all that matters is a healthy baby”. I think that every mother desires a healthy baby, but isn’t a healthy mom (physically and mentally) equally important?