I‘m regularly having discussions with women about when the right time would be for an induction or caesarean. Currently our Caesarean Birth rate is at an all time high and increasing year on year.
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MEDICAL NEED vs ROUTINE
I wanted to discuss reasons why we need interventions to illustrate when there’s a MEDICAL need for an intervention rather than a ROUTINE need (there’s a difference).
There are always times that some women need interventions, including caesareans. I wanted to list some of the times that I really believe that this is the right time.
REASONS FOR INTERVENTION
- Reduced fetal movement
If you don’t know about the Kicks Count campaign – then please follow it – it’s so important that you monitor you baby’s movements and any reduction or significant change then get checked out – this is absolutely one reason for an intervention as it could signal something going wrong.
One of the clients I worked with had this the moment she went into labour – she realised that the baby wasn’t moving and was very concerned. She went to hospital, was induced but then quickly went on to have a caesarean birth and there was an issue with the placenta.
This goes back to what I’ve said before that routine intervention at 42 weeks for an aging placenta is based on no evidence as placentas can age at any time – this mum was exactly 40 weeks – placentas can deteriorate at any time and reduced movements is one sign to be very aware of regardless of how many weeks pregnant you are.
- Pre-eclampsia or HELLP syndrome
This is absolutely a reason for induction or emergency caesarean birth. It’s normally diagnosed with severe swelling, headaches, increased blood pressure, visual disturbances, nausea or sickness and protein in the urine. HELLP is a much more severe form of it.
Going in for regular antenatal checks are vital to keep an eye on these and never being worried about getting in touch with your midwife or triage.
- A transverse baby
A baby who is transverse and doesn’t change position will need a caesarean birth – this is relatively rare but does happen. If you baby is transverse – swimming, yoga, chiropractor can all help. If you baby doesn’t move as you approach your due date, it is a reason for a caesarean birth.
- Low lying placenta also known as placenta praevia
This was something that affected me was that placenta was covering the cervix enough that it could have endangered my life and my twins lives. It’s relatively rare and even rarer that the placenta doesn’t move out of the way. It is definitely a reason for a planned caesarean birth.
- Cord prolapse
This is when the cord is underneath the baby’s head and is extremely dangerous – often it’s not identified until the time of birth and if it happens to you, you might find a midwife holding the cord in place whilst you head to theatre for a caesarean. It happens in about 1 in 200 births – so relatively rare.
MANY OTHER REASONS
This is not an exclusive list – there are other reasons and this is never to replace medical advice. I wanted to be clear that interventions are needed when there’s a MEDICAL NEED. It could be a whole host of other things happening.
INTERVENTIONS GONE MAD
I’ve heard anecdotally from some birth experts that they believe intervention rate should be between 5-7% of births. We are currently around a figure of 78% of all births having interventions, with 27.1% of them being caesarean births. We don’t have a definite number in terms of what we know the intervention rate should be.
I wanted to illustrate here why interventions are needed in serious circumstances – but the vast majority of interventions are NOT required.
There might be other reasons you might choose to have a caesarean birth or induction – maybe you’ve experienced severe birth trauma? Maybe you want to feel in control? Maybe you have tokophobia? Maybe there’s other issues private to you.
ROUTINE INTERVENTION ISN’T AN ADEQUATE REASON
Routine intervention due to maternal age, prolonged pregnancy (after 42 weeks), big baby and loads more are not always the right reason. In fact, what we are seeing in a country like the United States where the majority of care is based on routine interventions is a rise in perinatal mortality and adverse outcomes. This is discussed HEAVILY in the Birth Bundle.
PREPARATION IS KEY
My belief is strongly that you can always have a good birth and that preparation is key around how you are going to support yourself physically, emotionally and mentally around this time.
That is why, in addition to the Birth Bundle, I’ve recently created the Caesarean Birth Bundle. This is to address the complete lack of education around Caesarean Births so you can fully prepare yourself. That includes how to organise a Gentle Caesarean Birth.
Having a better birth doesn’t come from inaction – it comes from holistic birth preparation.
What are you going to commit to today?
Build confidence, get informed, allow yourself to relax and experience a much better birth.
Much love, Tricia x
DOWNLOAD FREE Resources Bundle so you can start to prepare for your birth and learn about the differences and how to get the best care for you.