Not long ago I posted about a poorly-researched and poorly-written article by the Associated Press on the rising rate of cesarean births in Iowa.

Lisa Houchins, a mom in Des Moines who is also education director for the International Cesarean Awareness Network, responded to the same article with this letter to the editor that the Register published earlier this week:

Regarding, “More U.S. Women Delivering Babies by Caesarean Section” (March 29): According to the World Health Organization, more than half of all Caesareans in the United States could be avoided. When used properly, a Caesarean can be a life-saving procedure. When used indiscriminately, C-sections introduce unnecessary risks to mothers and infants.

Women who deliver by Caesarean are more likely to have complications, including increased pain and recovery time, infection or death. Babies delivered by Caesarean are also more likely to suffer complications.

Women with Caesareans are at increased risk for miscarriage, infertility and complications in later pregnancies. Also, their future birthing choices can be severely limited. Some hospitals (including many in Iowa) and doctors are attempting to ban vaginal births after Caesareans.

Caesareans may be safer than they were 20 years ago, but that does not make them safer than a vaginal birth. C-sections are major surgery, and they should be reserved for times when there is a true medical indication. I encourage all pregnant women to educate themselves on how to avoid a Caesarean and how to have the safest and most satisfying birth possible.

April is Cesarean Awareness Month, and the ICAN website notes:

What is Cesarean Awareness Month? An internationally recognized month of awareness about the impact of cesarean sections on mothers, babies, and families worldwide. It’s about educating yourself to the pros and cons of major abdominal surgery and the possibilities for healthy birth afterwards as well as educating yourself for prevention of cesarean section.

Cesarean awareness is for mothers who are expecting or who might choose to be in the future. It’s for daughters who don’t realize what choices are being taken away from them. It’s for scientists studying the effects of cesareans and how birth impacts our lives. It’s for grandmothers who won’t be having more children but are questioning the abdominal pains and adhesions causing damage 30 years after their cesareans.

CESAREANS are serious. There is no need for a ‘catchy phrase’ to tell us that this is a mainstream problem. It affects everyone. One in three American women every year have surgery to bring their babies into the world. These women have lifelong health effects, impacting the families that are helping them in their healing, impacting other families through healthcare costs and policies, and bringing back those same lifelong health effects to the children they bring into this world.

Be aware. Read. Learn. Ask questions. Get informed consent. Be your own advocate for the information you need to know.

There is lots of information on the ICAN website, so if you or your partner or your friend is pregnant, I encourage you to check it out. C-sections can be lifesaving procedures, but it makes sense to take reasonable steps to avoid having unnecessary surgery.

The ICAN of Central Iowa website has statistics comparing c-section rates in the largest Iowa counties and hospitals.

If you want to avoid a cesarean birth unless it is medically necessary, ask about c-section rates when you are choosing a provider.

Don’t induce labor without medical need (for instance, because you hit your due date, or because you don’t want to go into labor over a weekend), because trying to induce a cervix that isn’t ripe is more likely to lead to “failure to progress” and a resulting c-section.

Consider getting a certified doula to help with childbirth education during pregnancy and to support the mother during labor. The website of Doulas of North America explains the benefits of having a doula:

Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences.

DONA International doulas are educated and experienced in childbirth and the postpartum period. We are prepared to provide physical (non-medical), emotional and informational support to women and their partners during labor and birth, as well as to families in the weeks following childbirth. We offer a loving touch, positioning and comfort measures that make childbearing women and families feel nurtured and cared for.

Numerous clinical studies have found that a doula’s presence at birth

   * tends to result in shorter labors with fewer complications

   * reduces negative feelings about one’s childbirth experience

   * reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans

   * reduces the mother’s request for pain medication and/or epidurals

Research shows parents who receive support can:

   * Feel more secure and cared for

   * Are more successful in adapting to new family dynamics

   * Have greater success with breastfeeding

   * Have greater self-confidence

   * Have less postpartum depression

   * Have lower incidence of abuse

Click through to find links to some research. Dads, don’t worry about the doula trying to take your place during labor. My husband is a huge advocate for doulas. She doesn’t do your job–she just helps the mother with practical advice based on training and the experience of attending many births. She will not freak out to see the mother in pain, and she will be able to reassure both parents if panic sets in while labor is progressing normally.

I know women who would have ended up with c-sections if not for their doulas. In one case, the baby was presenting with the cheek rather than with the crown of the head. The medical staff were convinced a c-section was the only way to get that baby out, but the doula encouraged the mother to try leaning and squatting in some different positions during and between contractions. After a few tries, the baby shifted, and the rest of the labor was over in less than 20 minutes.