Did you know that one out of three women who is pregnant today will have a C-section? 

I was shocked to hear this statistic from my friends at Childbirth Connection. Some of the reasons they cite for the rapidly rising C-section rate are:

• under-use of care that can enhance the natural progress of labor and birth, for example less emphasis on:
  • providing continuous labor support (by a trained or experienced companion)
  • encouraging women to be upright and moving during labor (not on their backs, a position that can inhibit labor)
  • ensuring that women are well-rested and well-nourished while giving birth
• side effects of widely used medical interventions: the likelihood of c-section goes up, for example, when:
  • caregivers try to cause labor to start (labor induction)
  • caregivers use continuous electronic fetal monitoring (EFM) to check the baby's heart beats
• the willingness of some caregivers to move to cesarean section before trying measures that may avoid the surgery, for example by:
  • failing to attempt to turn babies in a breech position (buttocks- or feet-first) to a head-first position in late pregnancy with hands-on-belly movements (external version)
  • failing to allow more time for a vaginal birth to occur due to pressures in understaffed hospitals and on busy caregivers
• pressures on caregivers today to practice "defensive medicine," for example:
  • caregivers may feel that performing a caesarean section reduces their risk of being sued or of losing a lawsuit should complications occur
• failure to offer women with a previous caesarean section a choice between VBAC (vaginal birth after caesarean) and repeat c-section:
  • more and more hospitals and caregivers are adopting a 'no-VBAC' policy, and a woman who wants a VBAC may be unable to have one due to these restrictions
• unwillingness to offer vaginal birth to women in some situations, for example:
  • a woman who makes an informed choice to have a vaginal birth with a baby in breech position may have trouble finding a caregiver who is experienced and willing to attend such a birth
  • a woman who is expecting twins may have trouble finding a caregiver who is experienced and willing to attend the vaginal birth of twins
• the growing perception that a caesarean section, and especially a planned (elective) c-section, is "safe":
  • although caesarean are safer now than before, the surgery still carries a broad range of short- and longer-term risks for mothers and babies
  • although planned caesarean offer some advantages in comparison with unplanned caesarean, the fact remains that surgery - planned or unplanned - poses a series of risks in comparison with vaginal birth.

ChildbirthConnection.com'sresearch has shown the three most important things pregnant women can do to increase their chances of having a vaginal birth:

• a birth setting with low rates of caesarean section and other labor interventions
• a caregiver who shares your goals and has a conservative practice style
• access to continuous labor support from a trained or experienced woman who will be available for you in labor.

Most pregnant women don't carefully choose their caregiver or their birth setting to minimize the risk of C-section, which inadvertently exposes their child to more risk.  The Childbirth Connection web site gives detailed guidance on how to choose a birth setting, a caregiver, and a labor support person. I just wish every pregnant woman had this information.