Reduce Your Risk for Cesarean: 9 strategies to consider
(written by Jessica Dufault, PT, DPT)
One in three births in the US results in a Cesarean birth.
While C-sections are absolutely necessary in certain situations—like placenta previa (where the placenta blocks the cervix) or uterine rupture—for most low-risk pregnancies, cesareans carry more risks than vaginal birth. This means that avoiding unnecessary C-sections is both possible and important.
Here are 9 evidenced-based ways to reduce your risk for Cesarean.
1. Pick the Right Doc
Choosing a healthcare provider with a low C-section rate can make a big difference. It's important to ask them questions like:
- "How many of your patients end up having C-sections?"
- "What's your take on C-sections?"
- "How long do you let labor progress before considering a C-section?"
Their answers can give you a good idea of their approach to childbirth. If they seem patient and supportive of natural birth, that's a great sign!
NOTE: The World Health Organization (WHO) recommends Cesarean rates should be 10-15% or less so know where your provider stacks up!
2. Consider Midwifery Care
Did you know that midwife-led care can reduce the relative risk of a C-section by 30%?! Studies have shown that midwife-led models of care are associated with less intervention and an increased likelihood of spontaneous vaginal delivery.
However, accessing midwives can sometimes be challenging due to factors like insurance coverage, fewer midwives compared to OB-GYNs, and certain policy restrictions.
3. Choose Your Birth Setting Wisely (if this is an option!)
Where you give birth matters! Freestanding birth centers have C-section rates around 6%, and home births are about 5%. In contrast, hospital rates can range from 9% to 30% but you can look for hospitals in your area that have the LOWEST rates of cesarean birth!
4. Be Cautious with Late-Pregnancy Ultrasounds
Getting ultrasounds late in pregnancy without a medical reason might lead to unnecessary interventions. About two-thirds of families are told they might have a "big baby," but only 10% actually do. These false positives can lead to discussions about C-sections that might not be needed (and approx 50% of these ultrasounds are inaccurate when measuring baby's size!)
5. Get a Doula Onboard
Having a doula can be a game-changer! Continuous labor support from a doula has been shown to reduce the likelihood of cesarean delivery by 39%!! This might be especially important if you are getting induced for labor.
6. Labor at Home before heading to hospital.
Staying home during early labor can reduce your chances of a C-section. If you're managing (or intent to manage) without pain medications and there is no medical indication to go earlier, waiting until active labor (4-5 cm dilated) reduces your risks to 4% vs 18% for those who go earlier.
7. Keep Moving During Labor
Movement is your friend! Walking, sitting, standing, or kneeling can help labor progress. Even with an epidural, try to change positions every 30-60 minutes.
Movement is key to pain management and moving baby down and out of your pelvis efficiently. This means using alternative comfort measures and trying not to get an epidural too soon (or at all), choosing intermittent fetal monitoring (vs continuous) and having a plan for using movement.
We teach you all the SPACE MAKERS before & during birth in the Opening Your Pelvic Pathway Course. Space means less work for the uterus to push baby through the pelvis. This means less pain and a quicker, more efficient birth process. Space = less risk for cesarean.
8. Opt for Upright Positions
Lying on your back with knees up is common during delivery, but not always the best. Upright positions can help labor progress and may reduce the risk of a C-section. Even semi-reclined (on your back) and sidelying had a 29% higher risk of cesarean when compared to upright birth positions.
9. Understand the birth process and prepare your body for birth
Birth education courses and physical tools for birth preparation can be helpful to:
✔️increase your confidence
✔️maintain an active role in the decision-making process
✔️learn how to work WITH your body
✔️reduce your risks for birth injury (like perineal tearing!)
✔️ have a positive birth experience
The Pelvic Floor Protection Plan (where you are now!) is a great start. AND if you also want to
- position baby well
- improve pelvic SPACE now
- know exactly how to work with your body and when (even before baby is passing through your pelvic floor)...
then you need OPENING YOUR PELVIC PATHWAY!!
Find a VBAC (vaginal birth after Cesarean) friendly provider if you've had a previous Cesarean and would like a vaginal birth this time.
There is a difference between a VBAC tolerant and VBAC friendly provider and you’re statistically more likely to get your VBAC with the latter. So, Google this! And make sure your provider ticks all the important boxes for you.
