First Ever “Preventing First Cesareans” Workshop
Last night was one of our most inspiring nights of birth stories; we held our first ever presentation of “Preventing First Cesareans” for a crowd at the 14th St. Y. Choices in Childbirth was inspired to put on this evening because there is a national push underway to reduce primary cesareans. In 2014, ACOG and SMFM released guidelines that suggest many changes to maternity care with the goal of safely reversing the upward trend in cesareans in the US (download CiC’s “Preventing First Cesareans” brief). Nationally 32.8% women give birth by C. In NYC, hospital rates vary between about 20 and 40%. If you venture to some NJ, Westchester and L.I. hospitals you will find rates that approach and exceed 50%. And yet, with all these surgeries, we haven’t seen an improvement in outcomes for mothers and babies. In fact, we are increasingly seeing the added risks to mothers and babies when cesareans are done unnecessarily.
Facilitator Mary Esther Malloy of Mindful Birth NY curated three “outlier” stories for the night, where labor was longer or the baby was larger than is typically the case and where the family’s choice of provider likely optimized their chances of giving birth vaginally. In another setting, or without the trust and respect between patient and provider we find in these stories, a cesarean would have been a highly possible outcome. In a sense, these are stories of “failed cesareans”. We also invited a family to tell their story of a positive experience of a birth by cesarean. This is as important as any other story on the panel because admittedly, it is rare to hear a story of a couple coping well with a Plan B, digging deep and finding ways to embrace cesarean as a birth, to appreciate the work they did to have as empowered and humanized a cesarean birth. After all, in human birth there appears to be an irreducible number where for some cesarean will be the safest and best way to birth a baby. And if you fall into this group, wouldn’t you want to have the best cesarean birth possible and embrace as fully as you can your child’s path through and arrival?
Certified nurse midwife, Rita Wagner, shared her approach to protecting physiologic birth whenever possible and prioritizing woman centered, family centered care. A strong theme throughout the night became the importance of finding a care provider who treats an expecting mom as a whole person. Rita skillfully addressed concerns about safety, advocacy, and questions of a more technical nature.