In many cases, the practitioner you choose can have a great impact on your chances of having a c-section. For this reason, it's important to do some research before you decide who will deliver your baby.
Different doctors have different opinions about cesareans, so ask them about their cesarean rate and discuss how they'd handle different birth scenarios, suggests Bruce Flamm, MD, an ob-gyn at Kaiser Medical Center in Riverside, California, and a spokesman for the American College of Obstetricians and Gynecologists. You'll also want to discuss what skills the doctor has for pushing a borderline situation toward a vaginal delivery.
For example, breech babies can sometimes be turned, notes Joseph Collea, MD, professor and director of maternal-fetal medicine at Georgetown University Hospital in Washington, D.C. Unfortunately, not all doctors are trained in the procedure, called external version.
Once you choose a practitioner, it's extremely important to communicate your wishes early on. If you let your practitioner know at the very beginning that you want to do everything reasonable to avoid a cesarean, she can proceed with that in mind and you're more likely to wind up with the birth you want, points out Dr. Flamm.
One important topic to talk about is how your doctor uses the fetal monitor. Once the monitor is strapped to your belly, you can't walk around or change positions, so ask your practitioner if she'll consider intermittent monitoring, which allows the patient to take off the monitor and move around. Numerous studies have demonstrated that walking around and changing positions can reduce the cesarean rate by speeding up the progression of labor.
If you've had a c-section in the past, ask your doctor or midwife about the possibility of a vaginal birth after a c-section, also known as VBAC. Though doctors used to think this scenario would cause the uterus to rupture along the scar line, advanced surgical methods have reduced these odds. For some women it's a safe option, so talk to your practitioner to see if it's an appropriate choice for you.
Reviewed 11/02 by Elizabeth Stein, CNM
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.