February 23, 2010

Birthing Choices and C-Sections - Why I Became a Doula


Doula-ing was born out of my desire to help educate and empower woman about their birthing choices. On the surface it appears very cut and dry. I peed on a stick, it came back positive, I go see my OB and nine months later my baby is born. Ok, maybe I’m over simplifying it a bit, but you get the point.

It’s not that cut and dry. From deciding which healthcare provider will care for you and your baby (obstetrician, certified nurses midwife, certified professional midwife) to where you will give birth (hospital, home, birth center) there are hundreds of decisions that aren’t so clearly defined that each woman should examine and decide which ones are best for her. As a doula, I want to provide as much information to help my clients make the best decisions for her and her family.

Blogger The Unnecesarean posted the map above showing the 2007 Cesarean Rates by state. It is important to note the the World Health Organization (WHO) recommends that for the best maternal and fetal outcomes that cesarean rates in industrialized countries should be no more than 10-15%. The map indicates that in 2007 the rate in my state of North Carolina was between 2.5 to 3 times what is recommended. According to the North Carolina State Center for Health Statistics, in 2008 the Wake County cesarean rate was 32%.

If Raleigh and Wake County’s rate is 3 times higher than is recommended for the healthiest outcomes for both mother and baby, shouldn’t we be asking questions? Shouldn’t we be asking why is the rate so high and by many accounts increasing? As an expectant mother, ask your healthcare provider what their rate of cesarean births are. Ask what their policy is regarding vaginal births after a cesarean (VBAC). Inquire about their rate of inductions and how many of those lead to c-sections. Educate yourself about your options. Ask questions. This is your pregnancy, your baby, and you are your best advocate.

Don’t misunderstand my questioning as a sign of not understanding the importance of a c-section. I am the mother of twin boys who very well might not be here if it was not for a c-section. My boys were in the same sac without a separating membrane. This rare twinning meant that their umbilical cords were in a knot and they were at risk of cord compression. Because of the knot, if they were not born via c-section, one or both of them may not be here. As a doula I have also attended necessary c-sections births.

C-sections are necessary medical procedures, but we as women and mothers need to educate ourselves about the medical situations that dictate the necessity and unnecessary interventions that can ultimately lead to a cesarean birth.

For additional resources visit The International Cesearn Awareness Network ICAN.

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