Hello again. You are thirty-four weeks now. We have answered a lot of your questions about childbirth over the last few weeks but we haven’t really touched upon c-sections. According to the National Center for Health Statistic’s latest reports, approximately 31% of moms giving birth in the United States will have a cesarean. With that in mind, we feel that it is very important for moms, especially first-time moms, to know more about c-sections. In this week’s newsletter we are going to tell you what you can do to reduce your chances of needing a c-section and also discuss some of the reasons for cesarean births. If you have had a c-section before you may be having a repeat c-section or you may be attempting a vbac (vaginal birth after cesarean). We are going to have some information for all you vbac girls in this newsletter as well.
What is going on with mom & baby
Baby: Baby’s crown to rump length is around 33 cm (13 inches). Your baby weighs about 2350-2550 grams ( 5.2-5.6 pounds). Your baby should be turned head down by now. His lanugo, very fine hair that keeps your baby insulated, should be disappearing now. His skin may be covered with vernix, a waxy white colored protective substance that covers newborn babies skin.
Mom: Now that you are close to delivering your baby, it would be best not to travel far from home. You should have a rear-facing car seat for your baby and know how to assemble it. You may be getting more anxious or irritable as you get closer to the day you will deliver.
This week’s Pregnancy Checklist
|Write out a childbirth cheat sheet for dad.|
|Purchase a photo album for baby.|
|If you have other children, prepare a bag with everything they need in it for when you go to the hospital.|
|Make sure to have comfortable shoes or slippers for your hospital bag.|
|Purchase sanitary pads for the hospital or when you go home from the hospital.|
|Take a new belly picture for your scrapbook or journal.|
What You Need to Know About C-sections
Here are some of the reasons for why you might need a cesarean:
Failure to progress: Once you are in active labor, your cervix will be checked for dilation. There are things your doctor or midwife can do to help speed up dilation if your labor starts to stall; however, if your cervix remains the same and your labor is not progressing, he may decide that you need a c-section.
Fetal Distress: You and your baby will be monitored during labor. If your baby shows signs of distress you may be advised to change positions. Sometimes changing positions will improve baby’s heart tones but if baby still appears to be in distress, your doctor will likely decide to do an emergency c-section.
Cephalopelvic Disproportion: Sometimes baby’s head will not fit through the mother’s pelvis. If you have a very small pelvis or a very large baby, you may diagnosed with cephalopelvic disproportion.
Placental problems: While your baby is in the womb, her life is supported by your placenta. The placenta supplies blood and oxygen to your baby. If there is a problem with your placenta, your baby is affected. Some conditions such as placenta previa or placental abruption put you and baby at risk. If you have placenta previa you may not be able to have a vaginal birth. Likewise, if you have a placental abruption your baby may need to be born via emergency c-section.
Maternal conditions: There are times when it is not ideal to have a vaginal birth due to conditions that affect mom. If you have diabetes, high blood pressure, are having a multiple pregnancy, preeclampsia or any other medical condition that puts you or baby at risk, you may need to have a c-section.
Avoiding a C-section & Vaginal Births after Cesarean
You may be wondering if there is anything you can do to avoid having a c-section. As mentioned earlier, about one in three moms will have a cesarean. Many of these are repeat cesareans but many are not. There are a lot of reasons why women end up needing to have a cesarean birth, some of the reasons are unavoidable, but there are things that you can do to increase your chances of having a vaginal birth or vaginal birth after a cesarean.
Ways to avoid having a c-section
- Choose a vaginal birth-friendly doctor. After all, your doctor will ultimately be the one to decide when and if you will need a c-section. Talk to your doctor. Find out how many births are cesarean and how many are vaginal. Find out as much as you can about your doctor’s feelings on c-sections. Things you may want to know are: What percentage of births in your practice are cesarean? What could come up during my birth that would require me to have a c-section? What will you do to help me avoid having a c-section? You should be able to get a good read on how your doctor feels about c-sections just by talking to him or her. Choose a doctor that seems in tune with your feelings.
- Be cautious with inductions. Towards the end of your pregnancy you may be offered an induction. Because inductions are an artificial start to labor, they don’t always work as well as if mom had gone into labor on her own. Normally, prior to labor, the mother’s cervix will start to thin out and dilate but when a mother is induced she is relying on medications and artificial means to start the labor process. Having an induction may increase your risks of needing a c-section, especially if your labor induction fails or your water is broken. Still, sometimes an induction is the best course of action, for example if you have preeclampsia or your baby’s health is at risk.
- Do some of your labor at home. When you first start having contractions, you may feel this urgent need to rush to the hospital. If this is your first pregnancy, you can probably do part of your labor at home. Walking around and moving is helpful for speeding up labor. Once you are at the hospital you may not want to walk around or feel up to moving around.
- Change positions during labor. During labor you may be tempted to stay in one comfortable position. If you have been laboring in one position for a while and you find your labor is not progressing, try switching positions.
- Ask your doctor or nurse for ideas. If your labor is not progressing ask for ideas. Sometimes your nurse, doctor, or midwife can help with suggestions on how to speed things along.
- Hire a doula. A doula is a paid labor assistant. Hiring a doula may improve your chances of having a vaginal birth. She can help be your voice when you are tired, give you advice, and help you to make decisions during labor.