Midwives are not trained to perform surgery or handle high-risk deliveries, but most are affiliated with hospitals or obstetrical associations. Be aware that if you end up having complications when you go into labor, a midwife will have to transfer you into the care of an obstetrician. Talk about the possibilities of complications with your midwife well before your due date approaches and add instructions to your birth plan about what to do in the event of complications during labor. Ask your provider how often she performs episiotomies. This is when a surgical incision is made during the second trimester to enlarge the vaginal opening for the baby to pass through. This procedure is becoming less and less common, but you should ask the midwife if this is something she practices. Midwives generally do not instruments like forceps or vacuums, as they are usually not trained to use them, and they generally do not have the privileges to do so. Be aware that these devices can be lifesaving to mom and baby, and can often prevent the need for a cesarean. Their patients generally require less pain medication (though some midwives cannot administer drugs or anesthesia, which may impact how many of their patients use pain medication). After delivery, patients report being happier with their experience. If you have a high-risk pregnancy, such as expecting twins or multiples, or if you have gestational diabetes, high blood pressure, or chronic health problems, it is not advisable to work with a midwife without an obstetrician.
Ask your obstetrician what her “primary cesarean rate” is. This number represents the percentage of first-time cesareans performed by your doctor. The number should be as low as possible, ideally around 15–20%.
A recent study showed that many pregnant women do not know about the services provided by a doula and as a result, are not reaping the benefits of doula care. Ask your obstetrician to recommend a doula or ask other mothers if they can recommend a doula. Some birthing centers may offer doula assistance as part of your overall care at their facility. Keep in mind the services of a doula will likely not be covered by your health insurance and doula rates can range from several hundred to several thousand dollars.
If you are giving birth at a birthing center or a hospital, ask them for a referral to a natural birthing class. Your doula may also be able to recommend a birthing class, if you are using the services of a doula.
Obesity is one of the biggest risk factors for requiring a cesarean. Optimizing your health prior to pregnancy limiting weight gain through exercise and proper diet can help lower your chances of a cesarean. Maintain a well balanced diet that contains the four food groups: fruits and vegetables, protein, dairy and grains. [8] X Trustworthy Source American Heart Association Leading nonprofit that funds medical research and public education Go to source Make sure your daily diet consists of five portions of fresh or frozen fruit, six ounces or less of protein like meat, fish, eggs, soya, or tofu, three to four servings of fresh or frozen vegetables, six to eight servings of grains like bread, rice, pasta, and breakfast cereals, and two to three servings of dairy like yogurt and hard cheeses. [9] X Trustworthy Source American Heart Association Leading nonprofit that funds medical research and public education Go to source It is also important that you maintain a healthy weight for your age and body type. Avoid being underweight or overweight while pregnant, as this can lead to complications and health issues. You can calculate your Body Mass Index (BMI) using an online BMI calculator and determine how many calories per a day you should be consuming to maintain a healthy weight. If you are concerned about your diet, ask your doctor or midwife for specific advice. If you have gestational diabetes or other complications, you will need to follow additional, specific dietary guidelines.
Do low impact exercises like swimming, walking, and yoga. You can also do targeted exercises made for pregnant women, such as ab exercises. Avoid exercises where you lie flat on your back after your first trimester, as well as contact sports, and activities that pose a risk of falling, such as skiing, surfing, and horseback riding.
It can be tricky to find a comfortable position to lie down while you are pregnant that will not endanger your baby. Try to lie down on your left side, with your legs bent. You can use a body pillow or several pillows on your lower back to sleep in comfort.
During a typical prenatal yoga class, you will learn breathing techniques, do gentle stretching, and do postures to strengthen your flexibility and balance. You will also be given a period at the end of the class to cool down and relax.
The first phase of labor is the longest, with mild contractions. Walking around, being on your feet, and squatting during this phase will help your labor continue in a healthy and normal fashion until you reach active labor. This phase of labor often occurs later than once thought by doctors, when your cervix is at least six centimeters dilated. Staying at home until you are in active labor and it is time for medical intervention can help to ensure a vaginal birth.
Try to avoid an “elective induction,” which is an induction done purely for convenience, rather than necessity. Instead, lean on your birthing partner, your spouse, or your doula and use the breathing and labor techniques you learned in a birthing class to encourage labor.
An epidural can limit your baby’s ability to move around in the womb, so if he is in a bad position he may have a hard time adjusting to a better position during labor. When you are given an epidural, your ability to move around will also be limited, which could lead to complications during labor. [15] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source You may be able to reduce some of the increased risk of needing a cesarean section by waiting until you are at least 5 centimeters (2. 0 in) dilated before you get an epidural or other pain medication. By that point, your labor is less likely to slow down or stop. It can also help to stay mobile during the early stages of labor by walking around and shifting positions while you are in labor. Avoid laying flat on your back, as this can make it more difficult for your baby to get in a good labor position, and prolong your labor. [16] X Research source
If your baby is a bad position during labor and may have a hard time passing through your pelvis despite hand movements to shift him, your obstetrician may use forceps or a vacuum extractor as a safe alternative to a C-section. Talk to your obstetrician about these procedures and specify in your birth plan if you would prefer these options to a cesarean section.
You should also specify in your birth plan that you would like a vaginal birth and give your obstetrician, your midwife, and your doula a copy of your birth plan. However, it’s important that expectant mothers always include a provision in their birth plan about what to do in the event a C-section is needed due to emergency medical reasons.
