Not every mother wants to avoid a C-section -- in fact, some request them -- but if you do, here are some tips for what to ask your doctor (or midwife) in the delivery room if the suggestion is made that it's time to give up on a vaginal birth and head to the operating room.
"Doctor, is this an emergency, or do we have time to talk?"
Sometimes you need a C-section to save your life, your baby's life, or both. In those cases, there's no room for discussion.
Delivery room emergencies include excessive bleeding, a breech position where the baby is headed out foot-first, or when the baby has certain heart rate problems.
"Doctor, what would happen if we waited an hour or two?"
The vast majority of the time, when your doctor or midwife tells you it's time for a C-section, it's not an emergency.
In many cases, women just need more time to labor. In fact, the No. 1 reason for a C-section is "failure to progress" during labor. If that's what we're talking about, then it's not an emergency.
"Doctor, are you sure the baby is too big for me to deliver?"
Sometimes parents are told a baby is too big to deliver vaginally. Dr. Ware Branch, medical director of women and newborns clinical program at Intermountain Healthcare in Utah, says parents should ask whether a C-section is absolutely necessary, especially if labor hasn't advanced very far.
"If it was my wife in labor and she's three or four centimeters dilated and the obstetrician says the baby's head is too big and she can't deliver him, I'd say, 'Nonsense, she hasn't really had a trial of labor, doctor.' "
"Doctor, is there something else I can try before having a C-section?"
Antunes, a spokeswoman for DONA International, which certifies doulas, says there may be options such as maneuvers like the one she used on Ste. Marie to get a slow labor moving.
"Doctor, can we talk more about the baby's heart rate?"
If you're told you need a C-section because of the baby's heart rate, try to get your doctor or midwife to be as specific as possible.
Some heart-rate problems mean a C-section is necessary immediately, but other types of heart-rate issues are not nearly as serious, and you may be able to labor longer.
"This is a very gray area," says Debbie Levy, a certified nurse midwife in Marietta, Georgia. "It takes years to learn how to read fetal heart tones, and it's not an exact science."
Levy says it can be difficult to ask these questions when the person delivering your baby says it's time for a C-section, especially since mom and dad are often exhausted.
"This is a very tough discussion to have in the delivery room," she says. "You're vulnerable, because you're talking about your baby's well-being."
But she says as long as it's not an emergency, you should have these delivery room conversations with your doctor or midwife.
"You shouldn't be afraid to speak up and say you'd like to try to labor longer," she says.
2 comments:
I have Strep B and have been told I'm on a time clock from the moment my water breaks. What if we hit the 24 hour point and I haven't "progressed" as they say? Is a C-section then medically necessary to prevent infection or can I argue that I just need more time if it looks like I'm getting close?
I am a NICU nurse and at our hospital we do go by the "24 hour point." Anything longer can increase chance of infection and stress on baby. However if you're getting pretty close (such as dilated to a 9 and 100% effaced) then the doctor may hold off.
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