Is This C-Section Rate For Real?

This week I went to the American Girl store in Dallas with my middle daughter (9) and a friend of hers.  We had a great time and went to lunch afterwards.  While we were waiting for a table, Abby's friend was telling about how she was born in the same hospital as a friend of hers, they have the same pediatrician, and born the same year.  I leaned over and told her that Abby was born at home in a big pool of water in our living room.  She was in total shock!  She said, "Did a doctor come to your house to get her out of your stomach?!"  (Abby seemed equally shocked by her reaction, which I must admit, made this mama proud.)

This is what girls growing up in America believe is normal -- babies being cut out of their mothers. 

I am certain that we are all aware that the rate of women having c-sections in the United States is about 1 in 3.  In North Texas, where I live, it's about 50%.  I have a friend that is a labor and delivery nurse at an area hospital and another that works postpartum at the same hospital.  They have both said there are days/nights that they do not tend to or witness a single woman that has a vaginal birth.  They are at a hospital that has a 60% c-section rate, but they have both told me they believe the rate is even higher.

I have another friend that works as a lactation consultant at another area hospital.  This is a portion of an email I received from her this weekend:

Out of 12 patients on the floor, 6 were c-sections.  Today's breakdown looked like this:

1 induction for "post dates" - mom was 40 weeks.  Ended in C/S

1 induction for "large for gestational age" at 39 weeks - baby weighed 7lb 9oz and ended up on antibiotics because mom ran a fever during labor.  Baby will spend an extra 2 nights in the hospital without mom for antibiotic therapy

1 induction at 39 weeks for "suspected ployhydramnios" - mom managed to deliver vaginally but baby is feeding poorly

1 induction for "post dates" at 40+6 - resulted in maternal fever, Failure to Progress, C/S and baby on antibiotics

1 "Term Induction" (whatever that means!) at 39+2

3 repeat C/S (1 at 36+ wk, 1 at 38wks and 1 at 39wks)

4 spontaneous labors, one of which ended in C/S for "Failure to descend"

Also this week, at the same hospital, a woman was told that she would have to have her birth plan approved by the legal department.   It was 11:30 p.m. and they would not be available to do so until the morning.  Her doula reminded her that she had options.  Yadda, yadda, yadda, she drove across town and birthed with the UNT Midwives in Ft. Worth -- no pain medication, cord wrapped around baby's neck 3 times, and water broken for almost 48 hours.   This couple would certainly have had a c-section had they stayed at their original birth place.   If that story doesn't inspire you to hire a doula, I don't know what will!

One of my couples had their baby at 37 weeks right before Christmas.  She had started bleeding pretty heavily, but it would stop when she laid down.  They suspected a placental abruption, but the midwife (yes, one of the UNT Midwives) and back-up OB couldn't see anything on the ultrasound.  She had lost quite a bit of blood, but they decided to wait it out.  Her contractions were sporadic -- short and not very strong -- and this went on for over 6 hours.  Baby was fine.  The midwife finally decided to break her water and things progressed from there.  She was catheterized so that she would not get up and start the bleeding again.   Her baby was born, posterior and wrapped in his cord, about 12 hours after the midwife broke her water.  No epidural.  As it turns out, she had had an abruption, but she had a large blood clot on the placenta that had stopped the bleeding.   Had it broken free, she would have had an emergency c-section.    I believe she would have had a c-section had she walked into the majority of the DFW hospitals bleeding like that.  Baby is nursing well and everyone is doing great.

So, yes, the c-section rate is crazy.  But we don't have to leave it to chance.  Do not ignore red flags.  If they are popping up at your hospital tour or monthly/weekly appointments, do not put a blindfold on and keep walking, hoping things will work out in your favor.  Tear it off and RUN!  There are care providers who will support you -- not just go along with you -- in your decision to have a normal vaginal birth.

Let's face it though, if I was an OB, I would be all over the c-section thing.  No waiting around, twice as much money, I'm the hero saving the day, and dang it, no one ever sues an OB for performing a c-section!