There are many things that can set you up for a successful natural birth and many things that increase your chances of a c-section. The most common explanations for why a cesarean was performed are "failure to progress," "fetal distress," "cephalopelvic disproportion" (your pelvis is too small) and the baby's positioning. Often these diagnoses are questionable and can be avoided.

Here are the top ten things that will improve your chances of a natural birth and help you avoid an unnecessary surgical birth.

1. Choose Your Care Provider Carefully

Interview providers before settling on the one you want. Ask about their rates of c-section, induction, and spontaneous natural births. Also ask about the other providers on their team. In most cases it is unlikely you will have your own doctor on the day you give birth. If you have a midwife you will have more consistency of care.

2. Avoid Induction

If your body is not ready to give birth and you are forced into labor it can lead to a painful and non progressive labor. C-section rates go up with induction rates. Avoiding induction is especially important if you are a first time mom.

3. Do NOT Get an Epidural

Epidurals commonly slow or stop labor leading to a "failure to progress" diagnosis and surgical birth to follow. They can also be the source of fetal distress leading to a cesarean birth.

4. Stay Off Your Back

Lying on your back or being semi-seated are the worst possible positions for giving birth. Do not get into either of these positions during labor or during/throughout delivery. Lying or sitting on your back decreases the size of the pelvis and may result in cephalopelvic disproportion or being told "your pelvis was too small to birth vaginally.".

5. Push Only When You Are Ready

When your body is ready to push it will push. Being told to push is not only unnecessary but can be harmful. Often women are forced into the pushing stage just because they have reached ten centimeters dilation. The hospital only "allows" you to push for a specified period of time before they will recommend cesarean surgery.

6. Say NO to Continuous Fetal Monitoring

It may seem counterintuitive but continuous fetal monitoring has not been associated with improved birth outcomes. No fewer moms or babies die when using continuous monitoring versus intermittent monitoring. The big difference between the two forms of monitoring is that the rate of c-section, forceps, and vacuum assisted deliveries increases with continuous monitoring.

7. Stay Home as Long as Possible

Staying home as long as you can is a key to a successful delivery. Presenting to the hospital in early labor increases the likelihood that you will have a birth filled with interventions. The longer you are in a hospital setting the more interventions you will be exposed to. Every intervention increases the likelihood of cesarean birth.

8. Avoid Vaginal Exams and Throw Out the Clock

Vaginal exams are not very useful in labor. The significance of how dilated you are is pretty minimal. Some women go from 3 cm to birth in 2 hours and some go two weeks at 6 centimeters. If you are having vaginal exams you will be expected to progress at a rate of 1 cm per hour or will be told you must be 10 cm by a certain time. If you do not fit this linear, one size fits all timeline, you will be labeled as "failure to progress" and will be told you must have a c-section.

9. Hire a Doula

Having a female support person who is familiar with what happens in labor and birth, a Doula, decreases the rate of cesarean by 50 %. Having continuous support focused completely on your family and your goals will improve your outcomes and your satisfaction with your birth.

10. See Your Prenatal Chiropractor

One of the big reasons for cesarean births is that the baby is not positioned well. If your baby is breech, posterior or any other less than optimal position seeing a chiropractor trained in Webster's In Utero Constraint Technique can help. Success rates are 85% and higher. Seeing a chiropractor throughout your pregnancy can prevent these malpositions and improve your overall body function. The brain body connection is essential for the progress of labor and can be optimized with chiropractic care.

C-sections are a valuable tool when they are necessary. When performed unnecessarily they can leave a woman scarred both physically and emotionally. Make educated and informed choices for yourself and set yourself up for success. If site you feel in control of the situation and make the choices for yourself, you can have an empowered birth even if a c-section becomes necessary.

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