With Rally Day fast approaching I’ve been digging up every fact and article I can get my hands on and posting it to our awesome ImprovingBirth page! Well, a few days ago I came across the most horrifying piece of information yet. The C-section rate in my province is 1 in 3, and is HIGHER than the rest of the country. I’m not kidding. This is disgusting and made my stomach turn because that means that we’re as bad as the entire United States! We aren’t even the biggest province and we’re that bad! 

So naturally I reacted with outrage and informed my family and friends. And they come back with “C-sections are life saving” and “well, some people choose them”. 

No. That’s not why our rates are so high. Sorry to destroy your illusions, but the World Health Organization has determined that only 5-15% of C-sections and other interventions are actually necessary in birth. Breech vaginal birth IS possible as are multiple births. The problem is not with women’s bodies or women opting out of birth (only 2% of C-sections are elective and 75% of women intend to birth without intervention, yet only 25% achieve this). Nope, our C-section rate is high because our medical professionals refuse to just sit on their hands and accept that they really aren’t needed unless there truly IS a complication. 

So here I’ve compiled a handy guide for moms to give to their care providers along with the birth plan, should anyone other than mom be feeling antsy about doing nothing and letting nature take its course.

Before labor starts

Scenario: Mom is expecting multiples/baby is breech/mom wants a VBAC (vaginal birth after cesarean).

Question to ask: Is mom healthy? Is the baby/babies healthy? 

Yes: STFU and let her go into labor on her own. If you aren’t comfortable doing a multiple/breech/VBAC birth then you should recommend someone who is or put on your big boy/big girl panties and GET COMFORTABLE WITH IT!

No: Discuss options with mom, including risks and benefits of induction and cesarean section and LET HER DECIDE. RESPECT THAT DECISION.

Scenario: Mom is of a small build and baby might be “too big” if she goes “overdue”

Question to ask: Is mom healthy? Is the baby healthy?

Yes: STFU and let her go into labor on her own. She’s got this.

No: Discuss options with mom, including risks and benefits of induction and LET HER DECIDE. RESPECT THAT DECISION. 

Scenario: Mom has gone past her “due date”

Question to ask: Is mom healthy? Is the baby healthy?

Yes: STFU and let her go into labor on her own. Baby will come when he’s ready and Mom’s got this.

No: Discuss options with mom, including risks and benefits of induction and LET HER DECIDE. RESPECT THAT DECISION. 

Scenario: Mom is measuring smaller than she should be and the ultrasound shows baby might be smaller than he should be. 

Question to ask: Is mom doing well? Is the baby active and showing no signs of distress?

Yes: STFU and let her go into labor on her own. She might need another few weeks since everyone grows at their own rate and babies are no different. Let baby decide when he’s ready to come out.

No: Discuss options with mom, including risks and benefits of induction and LET HER DECIDE. RESPECT THAT DECISION. 

Scenario: Mom is nearing 42 weeks with no signs of labor starting.

Question to ask: Is mom doing well? Is the baby still doing well?

Yes: STFU and let her go into labor on her own. Baby will decide when he’s ready.

No: Discuss options with mom, including risks and benefits of induction and LET HER DECIDE. RESPECT THAT DECISION. 

In early Labor

inigo failure to progress

Scenario: Mom has had irregular contractions for hours and is not progressing “fast enough” (whatever that means). 

Question to ask: Is mom doing well? Is the baby showing no signs of distress?

Yes: STFU and let mom do her thing in peace. Stress will only prolong her labor, not make her progress faster. Suggest she take a rest while she can and eat whatever she feels like eating. If she’s at the hospital suggest she go home to be more comfortable. If she’s already at home, maybe go away for a little while and tell her you’ll check on her a little later.

No: No: Discuss options with mom, including risks and benefits of augmentation and LET HER DECIDE. RESPECT THAT DECISION. 

In active Labor: 

Scenario: Baby doesn’t seem to be dropping/mom isn’t progressing/ baby is in bad position

Question to ask: Is mom doing well? Is the baby showing no signs of distress?

Yes: STFU and let mom do her thing in peace. Allow her support people to help her. Suggest mom move around into whatever position is comfortable for her and don’t be so quick to push drugs on her. 

No: No: Discuss options with mom, including risks and benefits of augmentation and LET HER DECIDE. RESPECT THAT DECISION. 

Scenario: Waters haven’t broken yet and baby is still high in the pelvis.

Question to ask: Is mom doing well? Is baby doing well?

Yes: STFU and let mom do her thing. Breaking the waters unnecessarily might put baby in a bad position, prolapse the cord, or cause immediate distress. 

No: Discuss options with mom, including risks and benefits of artificially rupturing membranes and LET HER DECIDE. RESPECT THAT DECISION. 

Scenario: Mom is dilated to 10 but waters haven’t broken yet and baby hasn’t dropped.

Question to ask: Is mom okay? Is baby okay?

Yes: STFU and let mom relax and do her thing. She’ll know when it’s time to push. 

No: Discuss options with mom, including risks and benefits of artificially rupturing membranes and LET HER DECIDE. RESPECT THAT DECISION. 

Second Stage:

Scenario: Mom has been pushing for over an hour with only a little progress.

Question to ask: Is mom okay? Is baby okay?

Yes: STFU and let mom do her thing. Try a more upright, gravity-friendly position.

No: Discuss options with mom, including risks and benefits of waiting it out vs an assisted delivery or C-section and then LET HER DECIDE. RESPECT THAT DECISION.

Scenario: It’s been almost 3 hours and while mom has been doing fine pushing on her own the baby is still not out yet. 

Question to ask: Is mom doing fine? Is baby doing okay?

Yes: STFU and let mom push at her own pace. Rushing her will only stress her out, possibly cause her contractions to stall, and make her tear unnecessarily.

No: Discuss options with mom, including risks and benefits of waiting it out vs an assisted delivery or C-section and then LET HER DECIDE. RESPECT THAT DECISION.

Scenario: Mom has chosen a C-section but wants her support people with her. She also wants immediate skin to skin/other practices done to her preferences.

Question to ask: Is mom doing okay? Is baby perfectly healthy?

Yes: STFU about policy and give mom a gentle C-section and immediate bonding with her child.

No: Explain the problem as to why x cannot be done, but try to follow the rest of the practices that CAN be done or suggest alternatives. Then LET THE PARENTS DECIDE AND RESPECT THAT DECISION. 

After birth: 

Scenario: Mom wants to leave before official discharge or wants other things that are not part of “policy” for either her or her child.

Question to ask: Is mom aware of the risks to what she is asking? 

Yes: STFU and let her decide for herself whether or not she should be able to go home, nurse her baby immediately after birth, have skin-to-skin or refuse any standard tests.

No: Discuss the benefits and risks with mom so she can make an informed decision on what is best for her and/or her child and then RESPECT THAT DECISION. 

See a pattern here? MOM is the boss, here. Not the medical staff. Not hospital policy. Not doctor’s preferences. Not sure what to do in a particular case? If you’re not the one giving birth then you don’t need to know what to do. Just ask MOM what she wants and then RESPECT THAT DECISION. 

Really, it’s that simple.

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