Expert Recommendations to Avoid “Unnec-Cesareans” & Enjoy Your Birth

Make informed health care decisions that are right for you, practice extreme self-care, use pregnancy and labor for conscious personal growth and prepare holistically for labor.

Make Informed Health Care Decisions

Choose a hospital with a low cesarean rate as it is the most important choice you can make. There are hospitals that have rates of over 60%! Call your local hospital/s and ask to speak with the Nurse-Manager of the birth unit. Request their annual “total cesarean rates” for each of the past several years. Also request the cesarean rate of your chosen provider or of their practice. Hospitals and medical personnel will often tell you their “primary cesarean rate” which is the rate of first time abdominal deliveries which will be a much lower number. Compare their total rate to the national rate. Their total rates give you a snap shot of the hospital’s birth philosophy and practices. If you have any issues getting this information, call the hospital’s obstetrical chief of staff or administration.

Find a hospital that has labor tubs/offers water births. Warm water immersion is well accepted as an effective labor comfort measure.  If your facility doesn’t have tubs ask them to purchase or install this basic inexpensive item. The first water birth I attended was in a progressive hospital that had an Aquadoula deluxe portable tub with disposable liners for hygiene. Be aware some hospitals and Obs are still on the fence about the safety of water birth and have policies discouraging it. Use the shower if the hospital does not have tubs.

Explore all possible birth settings including independent birth centers or the comfort of your own home. Sometimes hospitals offer a separate “natural” birth unit inside the facility, but in my experience these units are controlled by unrealistic medical protocols. The majority of women choose a hospital, but as more women are becoming disgruntled with obstetrical practice, births outside of institutions are on the rise. From 2004 to 2014, out-of-hospital births increased from less than 1 percent to 1.5 percent in the U.S. In 2014, 38,000 were home births and 18,000 took place at birth centers. Ninety percent of the home births were planned.1

Explore all your options for birth providers. You deserve a respectful provider who is “good medicine” for you. This person should be reassuring, informative, and expect you to have a healthy pregnancy and normal birth unless there are well documented medical problems. If you doubt their opinions, seek a different provider outside of that provider’s practice. Certified Nurse-Midwives, Certified Professional Midwives, Licensed Midwives, family practice doctors, naturopathic physicians and other classes of providers may be available. Search online, ask at health food stores or other holistic providers’ offices, such as chiropractors, for referrals. If you plan a hospital birth strongly consider Nurse-Midwife care. Another option, that I would not professional endorse, is freestyle birth. These are births unattended by any medical personnel. I know many women who are happy they gave birth this way, but I have also seen birth teams that were frightened by normal labor events and transported the woman to a hospital when there was no need. There are also less than ideal events that occurred that could have been avoided.

If there are no CNMs available in your local hospitals, you can contact the CEOs of your local hospitals and request they begin a Nurse-Midwife program. Hospitals respond to public demands for services. You can also contact your legislators and ask for changes in your state laws if home births or access to midwives is limited in your area. Lack of midwifery services is common because laws are heavily influenced by medical societies. Female legislators are often the authors of bills to change our outdated laws. Explore our resources tab for more information on your states’ laws and resources for holistic birth.

Learn the benefits of birth as nature designed it. The general public and many birth professionals are ignorant of this.

Educate yourself about the risks of commonly used interventions. The hospital and their medical personnel may believe you need many interventions so it is important for women to learn the downsides of routine interventions before labor.

Practice Extreme Self-Care

Focus on creating optimal health for you and your baby and preventing complications by moving more fully in the direction of a healthier lifestyle and seeking help for any issues or addictions that may plague you. We know people are more successful in resolving issues and freeing themselves of addictive patterns when they seek support and help.

Limit the “White Devils”. White flour and white sugar and high fructose corn syrup also. Natural sweeteners, especially agave nectar, have high glycemic indexes (they boost your blood sugars abnormally) but Stevia is a healthy sweetener that can be purchased in health food stores.  Truvia is a Stevia formula available in most supermarkets; if you consume lots of sugar you will need to adapt to the flavor of Stevia. Also limit fruit servings to approximately two per day because of the high natural sugar content

Nourish Yourself. Limit processed foods and strive for a whole foods diet with as much organic food as you can afford. The adage “eat for two” will lead to excessive weight gain as your baby is pretty little. Once you have reduced processed foods, that can be addictive, dramatically you can usually let your natural body’s desires guide your food choices. Whole grains are healthy in normal portions and approximately 75 grams of protein daily is considered adequate. Buy a high quality prenatal vitamin and take it daily. My favorite is Rainbow Light prenatal vitamin (available in our online store) but there are a variety of high quality vitamins on the market. There are many sites that offer pregnant women nutritional guidelines. Eating disorders, such as compulsive overeating, binging, anorexia or bulemia are very common and women suffering from these are encouraged to seek help. Overeater’s Anonymous is a holistic 12-step program for all these disorders.

Stay hydrated, drink mostly water. Approximately 2 liter/quarts a day is adequate but this will vary depending on weather and activity levels. Consider buying a high-quality water filter to purify your water to decrease exposure to toxins. Avoid drinking out of BPA plastic bottles (see below). Pee Test: You know you are hydrated if you pee in a clear glass and your urine is clear or light yellow and not the color of dark amber beer.

Ensure normal Vitamin D levels. Vitamin D is crucial for innumerable functions in our bodies and is made when our skin is exposed to sunlight. There is research that women with low D levels have longer labors and more cesareans.2 Ask your provider to check your total serum 25(OH)D which is currently considered the best indicator of vitamin D supply.3 Make sure the correct test is ordered as there are several D tests available. A normal result is 20-100 ng/mL but it is recommended by the American College of Nurse-Midwives to keep your levels above 30.  Up to 2,000 I.U. of Vitamin D3 daily is considered safe in pregnancy if your level is under 30.4  The amount of Vitamin D from foods, sun exposure and your prenatal vitamin may not be sufficient.

Find fun movement. Walk for at least 30 minutes 5 days a week or do some other safe pregnancy exercise and/or yoga. Any yoga teachers should be able to adapt their classes to accommodate a pregnant woman but you need to tell them you are carrying a child. Very active women can generally exercise to the level they are accustomed to before pregnancy but my experience is many women need to back down a bit. If you are initially unable to walk for 30 minutes, work your way up to this healthful goal. This is rare but extreme athletes may have excessively strong pelvic ligaments and muscles that can lead to a difficult delivery.  Extreme athletes should consider lightening their routines especially of their lower body.

Maintain a healthy weight based on your pre-pregnant BMI (body mass index). Intentional weight loss is not recommended in pregnancy but some women will lose weight from nausea/vomiting or because they improve their eating habits. Your health care provider or a nutritionist can guide you.

Avoid chemicals that disturb hormonal balance which are named hormone or endocrine disruptors. They are contributing to decreased fertility rates5 and men from the western world’s sperm counts are down 50%.6 Pregnancy and labor are dependent on healthy hormone production so this may be another factor affecting labors. Hormone disruptors may pose the greatest risk during prenatal and early infancy development when organ and nervous systems are forming. BPA (Bisphenol A) is a common chemical found in some baby and plastic water bottles, food cans, bottle tops, food storage containers, polycarbonate table wear, compact discs, impact-resistant safety equipment, medical devices, water supply pipes, some dental sealants/composites and breastmilk. Limit exposure by:

  1. Not microwaving polycarbonate plastic food containers.
  2. Avoiding plastic containers marked with recycle codes 3 or 7 which may be made with BPA.
  3. Reduce your intake of canned beverages and foods.
  4. When possible, opt for glass, porcelain or stainless-steel containers, particularly for hot food or liquids.
  5. Use plastic water and baby bottles that are BPA free.3 We offer these in our store.

Limit Toxic Exposures. We are exposed to innumerable toxins in modern life and how they affect labor is unknown. Electromagnetic radiation seems to be increasing miscarriage rates dramatically.[1]7 There are many sources of electromagnetic fields (EMFs) including your cell phone, cell towers, wireless devices etc. Don’t carry your cell phone in your pocket or near you while sleeping; even a few feet can decrease your exposure.8 Limit contact to chemicals including those in many household cleansers. Wear gloves for dishwashing, never mix ammonia and bleach, avoid chlorine fumes, etc. You can use baking soda, vinegar, and other natural products found in many stores. Check out your health food stores for more options.

Use Pregnancy & Birth for Conscious Personal Growth

Notice negative patriarchal influences. This paradigm is resulting in the unnec-cesarean epidemic so it is a great asset to become aware of these influences. Once you can identify them you can respond to them in a life-affirming way that will heal both sexes.

Examples of these influences include:

  • Providers referring to healthy pregnant women as “patients.” In my private practice, I referred to healthy women as “clients.”
  • Providers being too busy to answer your questions (production and profit are valued over relationship, client education and client participation).
  • Setting the stage for a cesarean at the first prenatal visit with dubious comments such as, “Your pelvis is small,” though we are rarely able to predict if the baby will fit your pelvis before labor.
  • Physicians comments to me that women interested in a holistic birth experience are being selfish!
  • Women apologizing for crying or expressing other emotions in the exam room. (Emotional repression is a masculine value).
  • People, including women and women’s health professionals, referring to grown women as girls.

Acknowledge and welcome your fears, worries, anxieties. Almost every woman will encounter fears when she is pregnant. You have the advantage of being more emotionally sensitive now which can help you access and identify your emotions more easily. Begin by noticing when you feel fear and anxiety. Who are the people who increase feelings of fear and who are those that reassure and inspire you?

The natural tendency to suppress fear will not work! Welcome your worries and anxieties into your awareness.  You want to face them but refrain from indulging in them. Writing down fears is a useful tool because what may sound like reasonable thoughts in your mind may seem irrational on a piece of paper. Learn to be compassionate with your fears; soothe and reassure them just as you would a frightened small child. Ask for reassurance from others as needed.

Pay attention to your thoughts. Negative thoughts create the distressing emotions. We were all given very powerful minds but many of us never had training in how to use them in a useful way. Many people’s minds are like wild horses trapped in a corral running amok and creating havoc. Notice negative thoughts and begin to release them and choose thoughts that make you feel better.

Decide from love instead of fear. Pregnancy & birth are awesome personal growth opportunities to learn more deeply about yourself. They are biologically built-in female rites of passage or initiations and the perfect metaphor for living life. Life will bring you many challenges; how do you wish to approach them? Do you want to submit to your fears or choose to face and overcome them? Life is actually very simple as with each decision we get to choose to let love or fear guide us.

Heal your pain body. The recommendations above for being with fears in a constructive way, releasing fears, and choosing love begins to heal the pain body. Each pain body is unique based on a person’s past. I invite you to begin the gentle transformation of your pain body to improve your health and experience a smoother labor. Remember resentments block our natural life energy flow and can eventually cause symptoms in our bodies. True forgiveness is a misunderstood art but when used effectively will heal resentments. The ideal is to gradually open to all of your emotions, despite living in what can be an emotionally undeveloped society. Be gentle with yourself, but begin to be honest with yourself, including when you are feeling “negative emotions.”

Set boundaries. Plan how you will deal with those who will tell you your baby is too small or big or share birth horror stories with you. “Thank you but my baby is the perfect size,” or “We are planning on a lovely birth,” are good ways to politely end negative conversations. Curiously, normal social boundaries change when women become pregnant. Complete strangers become friendlier and may want to touch you or your belly. It appears people unconsciously think you are now “community property” since you are bringing in a new member of the human race. If you are not comfortable with being touched this way, plan ahead how to tactfully care for yourself. Every time we set a positive boundary we gain a bit more personal power and strength. Avoid watching many of the highly medicalized births depicted on TV or in the movies and also consider limiting your exposure to other types of frightening and negative shows and influences. We have great positive birth films available to stream or purchase in our store.

Be with Mother Nature daily even if it is with a plant in your home. Nature can be very calming and spending time with her can help tune you into the rhythms of the earth, connect more deeply with your body and inner self. You are a part of nature and it is the animal part that knows how to give birth instinctually. Also the innate intelligence of Nature is growing your baby. You don’t normally try to control your blood circulation or digestion since we know they function automatically. Remember pregnancy and birth are natural processes for healthy women and you were made to give birth.

Remember, the Force is With You but most of us need to develop a conscious connection with that Higher Power. People have different names for this invisible power such as God, Goddess, Source, the Universe etc. We live in a very externally oriented culture; to give birth we need to go deep inside ourselves and find hidden resources and reserves. Daily quiet time allows us to relax and begin to receive guidance for our lives. In Chinese medicine, meditation is considered the most important thing you can do for your health. Quiet time can include reading inspiring books, prayer, formal meditation, contemplation of spiritual ideals, journaling, listening to birth positive guided meditations etc. You can check out our store for birth meditations and other inspiring resources.

Surround yourself with birth positive influences including women in your community and online. Read the birth stories in my blog or check out the birth story collections I suggest in our store. I do not recommend “What to Expect When You Are Expecting”; it has useful information but is not holistic and may increase your fears.

Ask questions & speak up! You may be an assertive person who is good at using her voice but many women are not. The patriarchal system has often insidiously trained women to be quiet and sweet. This conditioning can be deep but I encourage you to start using your voice to express yourself. You deserve excellent care so if you don’t understand explanations or recommendations, or you aren’t happy about something that happens, I encourage you to speak up. Your care providers are there to serve your needs. If you feel intimidated by a medical professional consider imagining them standing in front of you in their underwear to help realize they are just humans like yourself.

Prepare Holistically for Labor & Birth

 Design a birth altar. This highly effective tool does not need to be religious. It can calm your mind and reduce anxiety. Birth altars can be simply a piece of fabric on which you place items that are symbolic for you of pregnancy, labor, birth and motherhood. A small bowl of scented water with a flower afloat, images of opening flowers, a decorated candle or statues of the Virgin Mary, goddesses or mother and baby, notes with inspiring words, birth art, crystals, etc. Many women have hung “A Midwife’s Prayer” (on home page) on the wall behind the altar. Set it up in an area you pass by regularly. It can also be brought to the hospital for active labor.

Birth is such a sacred event that I think we need to bring more sacred symbols into our hospitals and lives. Altars are also useful healing tools if there is a death, trauma or tragedy in your family during pregnancy. When people who are important to me die, I light a tall glass enclosed candle and burn it constantly while I am at home. I place a photo of the person near the candle. The candle’s presence calms my mind and soothes my grief.

Strongly consider hiring a doula for your first birth especially you are planning a hospital birth. Continuous labor support by a woman reduces the need for pain medications, interventions and cesareans. If you have a Nurse-Midwife she will be attentive, but she may also have other women in labor. Most nurses will not be able to stay at your side constantly because of other duties. If you plan a homebirth a doula will not be essential as your midwife will be with you most of the time.

Doulas are not in widespread use in hospitals because our techno-medical models focus on pharmaceutical solutions instead of loving, human support. Some progressive hospitals have doula programs or there may be doulas who have completed their training who need more experience and will commit to being at your labor and birth at a discounted fee. Many first time laboring women want a woman who has had a normal birth with them. Male partners may be comfortable with labor support but many are relieved to have a doula or midwife guiding the process.

Stay home until strong labor which is generally when waves (contractions) are every 4 minutes with a first baby, and every 5 minutes with a second child for an hour or more. In strong labor you will probably have to stop and breath through the waves. Many first-time laboring women are not in active labor until they are 6 centimeters. Avoid being admitted before strong labor because it increases your risk of many interventions. You are generally better off at home where you will be more comfortable and can eat and drink as you wish. Easily digested foods such as fruit, oatmeal, yogurt and toast are often appealing. Avoid heavy meals. Stay hydrated! Someone should encourage you to drink 12 oz. of non-caffeinated fluid every hour. I advise you have Recharge, a natural Gatorade, available.

Request a holistic RN when you are admitted to the hospital in labor and present your birth plan. A nurse passionate about facilitating optimal births will be a great ally for you. Techno-medically oriented RNs may not be your best labor attendant.

Move freely in labor. Unless it is medically necessary, avoid being strapped to a monitor continuously. Ask staff to listen to your baby’s heart rate intermittently with a hand-held Doppler device.

Stay flexible. If you have perfectionistic tendencies, intend to soften them. Rigid belief systems or plans are often counterproductive. Birth is not a competitive sport or a performance and your value as a person is not dependent on the outcome. If the birth doesn’t turn out the way you expected, process your emotions, be gentle with yourself and ask what the lesson may be. Don’t blame yourself but do hold the providers and others accountable when appropriate. Holistic births include highly medicalized births and cesareans when they are what was needed for your and the baby’s safe passage.

Consider hiring a Transformational Pregnancy Coach for group or private sessions to help you navigate the many choices you have to make and assist you towards an optimal birth.

 

References

  1. Doyle, K. (2016, March). Out-of-hospital births on the rise in U.S. Reuter’s Health. Retrieved from https://www.reuters.com/article/us-health-homebirths/out-of-hospital-births-on-the-rise-in-u-s-idUSKCN0WU1G1
  2. Scholl, T. (2012, April). Maternal Vitamin D Status & Delivery by Cesarean. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3347011/
  3. Nguyen, H. (2014, Feb). Vitamin D3 25-Hydroxyvitamin D. Medscape. Retrieved from emedicine.medscape.com/article/2088694-overview
  4. Committee on Obstetric Practice, Committee Opinion, Number 495. (2011, July, Reaffirmed 2017). Vitamin D: Screening and Supplementation During Pregnancy. American College of Obstetricians and Gynecologists Website. Retrieved from www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vitamin-D-Screening-and-Supplementation-During-Pregnancy
  5. Bisphenol A (BPA). Endocrine Disruptors. National Institute of Environmental & Health Sciences. Retrieved from www.niehs.nih.gov/health/topics/agents/sya-bpa/index.cfm
  6. Western sperm counts halved 50% in 40 years. (2017, July). Pub Med Health. Retrieved from www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-07-26-western-sperm-counts-halved-in-last-40-years/
  7. Kaiser Permanente. (2017, Dec). New KP study provides evidence of health risks linked to electromagnetic field exposure. Retrieved from https://share.kaiserpermanente.org/article/new-kaiser-permanente-study-provides-evidence-of-health-risks-linked-to-electromagnetic-field-exposure/
  8. California Department of Health, Division of Environmental and Occupational Disease Control. How to Reduce Exposure to Radiofrequency Energy from Cell Phones. Retrieved from https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/EHIB/CDPH%20Document%20Library/Cell-Phone-Guidance.pdf

 

Vanita Lott, Certified Nurse-Midwife, Transformational Holistic Pregnancy Coach

Founder of Awakening Birth Now.com, Awakeningbirthnow@gmail.com

 

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