Ask a Midwife: Reducing Your Risk for C-Section

Ask a Midwife is a new blog series from Adriatica Women’s Health. Hear directly from midwives on topics like reducing c-section risk, considering a VBAC, pregnancy in a pandemic, and more. This conversation is with Courtney Watson, a Certified Nurse Midwife who is on a mission to empower women to make positive healthcare decisions.

Stephanie: Hi Courtney, it’s a pleasure to speak with you. I’m a mother of two young children, and I’m eager to learn more about midwifery. What made you want to partake in this blog series?

Courtney: I’m passionate about education and spreading knowledge, so I’m happy to be a part of it. I chose the topic on reducing the risk for a c-section because it is one of the most common fears I discuss with clients.

S: I’m eager to learn more. Before we jump in, I want to start with a foundational question. What’s the difference between an OB/GYN and a midwife?

C: Physicians are trained in the needs of high-risk pregnancies and surgeries. They’re equipped to handle the worst-case scenario. While that offers peace-of-mind, research says that for healthy, low-risk pregnancies, midwives can improve outcomes and provide higher satisfaction. So for women out there starting their pregnancy looking at options for providers, a midwife may be the right fit. Midwives have expert training in normal birth and the recognition and treatment of emergencies, should they occur. But most importantly, our focus is on customized, individualized care. It’s about you, your experience, and assisting you in making educated choices along the way throughout your journey.

S: I remember c-section rates being a big factor in how I “shopped” for my provider. There’s definitely a lot of discussion around c-sections. 

C: A c-section is a good tool, but when used in excess it can increase the risk of complications for mom and baby. Statistically, women are safer when they have a vaginal birth, so as midwives we do all we can as experts in vaginal birth to prevent the need for a c-section.

S: How can pregnant women play an active role in preventing c-sections?

C: So much starts with your initial research in choosing a provider, certified doula, and a place to birth. Ask your provider what their c-section rate is. Research the c-section rates at the hospitals in your area. According to the World Health Organization, the ideal rate is between 10-15%, yet the United States averages more than 30%. Look for a provider that is working to lower that national average. Ask them what they are doing to support vaginal birth and reduce c-sections for their clients.

S: What kinds of answers should we expect when asking a provider about avoiding a c-section?

C: The best thing we can do to prevent a c-section is to support normal physiologic birth. For low-risk women this looks like encouraging spontaneous labor, laboring at home during early labor, staying upright and mobile in labor, using a doula for bedside labor support, and adding interventions only when the benefits outweigh the risks. This list can be customized to each person for their birth.

S: I remember feeling unsure and sometimes powerless in many decisions during labor and delivery. It’s a difficult time to make tough decisions.

C: Choosing a birth team that you trust and have confidence in is crucial. Is the provider someone you trust – someone you feel will give you the necessary information and options, then support your decisions? Does the hospital support low-intervention birth? A doula can reduce c-section rates by 30%; they can be an invaluable part of your support. It’s a team effort. You want to pick your birth team wisely to help you through these difficult decisions and support you so you can have the best possible outcomes as well as a positive experience

Find out more about Courtney Watson and Adriatica Women’s Health, and follow the discussion around women’s health on social media.