E113: Tips to Avoiding a C-Section

One number quietly shapes a lot of birth experiences: the cesarean section rate. When about one in three US babies is born by C-section, it raises a big question for anyone planning a birth: how many of those surgeries are truly necessary, and what can we do to lower the odds of an avoidable one without turning birth into a battle plan?

I walk through the real factors that push C-section rates up or down, starting with the two choices that often matter most: your provider and your birth setting. We talk about what to ask in prenatal visits, including primary cesarean rates, how your team handles slow labor, and how long they have seen pushing still end in a healthy vaginal birth. You will also hear why midwifery care and hospital culture can change your experience more than you might expect.

Then we get practical. We cover pregnancy movement, pelvic mobility, fetal positioning, and ways to protect mobility during labor even if you get an epidural. I also dig into pregnancy nutrition as a neglected tool, with simple guidance around protein, fiber, and reducing sugar to support steady blood sugar and reduce common complications. Finally, we talk early labor strategy, when it is safe to stay home longer, and why continuous support from a partner, doula, nurse, or midwife can lower interventions and build confidence.

If you want evidence-informed, down-to-earth tips for avoiding an unnecessary C-section while staying ready for the real moments when surgery saves lives, press play. Subscribe, share this with a pregnant friend, and leave a review with your biggest question about C-sections or labor support.

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Show Credits

Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker

Transcript

Welcome And The Cesarean Yardstick

SPEAKER_00 0:10

Welcome to the Ordinary Doula Podcast with Angie Rogier, hosted by Birth Learning, where we help prepare folks for labor and birth with expertise coming from 20 years of experience in a busy doula practice, helping thousands of people prepare for labor, providing essential knowledge and tools for positive and empowering birth experiences.

Necessary Surgery Versus Overuse

Choosing Provider And Birth Setting

Movement And Pelvic Alignment Prep

Nutrition That Lowers Pregnancy Risks

Staying Home In Early Labor

Continuous Support And Teamwork

Protecting Mobility Even With Epidural

Patience With Induction And Pushing

When Cesareans Are The Right Choice

Closing Takeaways And Connection

SPEAKER_01 0:52

And as always, I look forward to being with you and spending a little bit of time with you. I wish we could hang out in person and uh chat with chat with each other as we um discuss so many different aspects of pregnancy, labor, birth, postpartum, breastfeeding, all of those things. Um, so today I want to talk to you about something that I find fascinating and frustrating and something that I use as a a yardstick, if you will. It's kind of like my measuring tool as to, I don't know if success is the right word, but um brilliance maybe in the birthing world. And and I I guess like if if I look at this measuring stick, it depends on how we're utilizing this and how we're avoiding this and um percentages and prevalence and probability, like this this kind of gives me a good idea of um, I don't know, provider style and things like that. And that is cesarean rates and or the use of c-sections um for for labor delivery and birth. So we know that the c-section rate in the United States hangs out around 30 to 33 percent, and it's been that way for a really long time, like over 20 years. Um, I pulled some stats from a nearby hospital local to me, and and they'll so far this year in 2026, the first three months, they're are hanging right there. They're at about 29%. Fluctuates by the week, of course. They get as low as what I've seen, like 25%, but um they're hanging at about 29% for um three months or so. So that's holding true there. Um, and I'll have to do a whole nother episode on cesarean section and NICU stays too. That's kind of interesting. We know that um the likelihood of a baby going into the NICU goes up uh when they're born by cesarean, and they're more dangerous to moms. I'll save that for a different episode. Um, but kind of using it as a measuring stick, like how to avoid them, why is the rate so high? There's lots of different factors that go into that. So, because about one in three babies are in the United States are born by cesarean, um, there are things you can do during pregnancy and during labor that can reduce the chance of an unnecessary cesarean. So there are necessary C-sections, and this is a procedure, an operation um uh that we are incredibly, incredibly grateful for. We're good at it in in so many places. It's actually as for a major abdominal surgery pretty simple as far as um, you know, we've done it a lot, uh, we've got it down to really good science. We can keep the risks of major surgery low. However, the risks are still there. Um, so the things you can do during pregnancy, right? Um, and during labor, we can't control everything, but there are definitely some things we control. So yeah, just I want to normalize to that balance of realizing some cesareans are necessary. There's some, you know, people are on both sides of this issue, of course. I teach childbirth classes at a couple of local hospitals and um had a student in one of my classes recently who she just wants a c-section. Like that's that was her plan. That's what she wanted, that's what she's most comfortable with. I don't know if she's looked into it and all her options. She was kind of upset when her provider said, nope, I'm not just gonna do an elective c-section on you. Um, and no, we're not just gonna do it 37, 38 weeks or whatever. Um, so there's people on that side, but there are other people who are absolutely devastated if they have to have a cesarean. And then there's a lot of people in the middle, right? Who are like, yeah, I had a c-section. And it doesn't um they don't they might not want it per se, but it doesn't kind of crush their world if they have one. So kind of, I guess the goal here is having informed preparation. Like when you know how to prepare, either to avoid one or to have one, prepare for a sec C-section, um, that supportive gear care can help us um feel more confident in our situation, actually, in avoiding or accepting true need of that. So one of the biggest things you can do is select a provider who um likes to avoid cesareans, a provider who's gonna support you if that's what you want, right? A provider who's gonna support you in avoiding a c-section is gonna be a huge one. So talking to them about that, like um they know these statistics, whether they share them or not, but ask them how many of their first-time moms, if you are a first-time mom, um, have c-section. Like, what is their c-section, right? That'd be a primary cesarean, we call that. Um, you can also ask, like, how long have you seen pushing last? Um, and there's so many different factors to that. Not like how long do you allow for pushing, but how long have you seen it go and have it still be a successful vaginal delivery? I my top that I've seen pushing with a vaginal delivery is nine hours. Now that's wildly long. I've seen six, seven, and eight. Um, and a couple years ago a nine that resulted in a vaginal delivery. Pretty unique circumstances there. Um, and sometimes we see a lot of pushing six, seven hours. And usually providers don't like to go more than three or four. We have to have a really strong case that it might work. Um, a patient who's willing to do the work and is patient, a patient who's patient enough to and strong enough to keep going. Um, that's a piece of it as well. But yeah, so how ask kind of how long have you seen pushing work? Um, and then what do we do about ask your provider, what do we do about a slow labor? Like, what are you gonna do about a slow labor? Because we got to understand sometimes labor is super slow, especially those early stages. We gotta be patient and let it kind of take its course in a very cautionary way. Um, the midwifery model of care often has lower cesarean rates. Um, there are hospitals, every hospital has their own climate, if you will, their own culture about how they approach labor and birth. Some hospitals have lower C-section rates and lower intervention rates. Um, some hospitals have higher NICU admissions, um, some have high induction rates. So kind of ask around, get some data on the hospitals that might be available to you as well. Um, but that this goes to show that there's a pretty impressive impact of your providers and your place policy about this. Um, so where you give birth and with whom you've given birth matters almost more than anything else in whether or not you're gonna have a cesarean. So also before labor ever begins, there's some things you can do to prepare your body for labor and prepare to, if at all possible, avoid a cesarean. And it is most of the time quite possible to avoid a C-section. So preparing your body, um, realizing labor progresses um slowly sometimes, and it could be cur it can progress smoothly when the body and the baby are well aligned. So that like movement, if I could have people do one thing during labor, it would be to move, like regular movement, upright positions, walking. And this is during pregnancy, right? We are a reclining society. We recline a lot. Um, and movement will be helpful to that. So that's pelvic mobility, that's helps facilitate good fetal positioning, so things you can do during pregnancy. Um, there's great websites like spinning babies that's gonna be very helpful to get you to understand how babies rotate, how they descend. Um, the help you kind of map out where your baby might be in your body. Um, also prenatal chiropractic care that helps align pelvises. So the pelvis is in alignment, it's not gonna be torqued, it's not gonna be tipped. Um, it gives like the straight shot for babies. So kind of focus on some comfort, balance in the pelvis throughout the pregnancy period. And you do have a nice opportunity to work with the pelvis during pregnancy because the hormone relaxing is helping everything to be pretty responsive to movement, which is nice. Um, another thing that is really not mentioned a whole lot, um, to my great dismay, is nutrition. Like if you can pay attention to pretty awesome nutrition during pregnancy, um, that can impact your chances of having a cesarean. So focusing on protein, like um pretty good intake of protein, 100 grams or more is going to be awesome during pregnancy. Your the baby's body, every cell in that baby's body is built of amino acids and protein, the cord, the placenta. As you build these things, protein is the building blocks for that. And also avoiding white sugars, white flowers, um going for protein, vitamins, sorry, protein, and then fiber, vitamins and minerals found in fruits and vegetables of all awesome variety. So that helps us not get babies who are kind of too big. We're we we see trends in the United States, and one of them um is increase in gestational diabetes, increase in preclampsia. There are a lot of factors to this. Nutrition's not the only one, but certainly a very neglected one. So please during pregnancy, eat well. Um, eat kind of like you're a diabetic and learn what that means. High protein, low sugars, no sugars, um, high fiber. That's gonna be something you can do during pregnancy as well. Whether you're four weeks pregnant, just early on in the process, whether you're 30 weeks pregnant. Um, I had a, I was teaching a class the other night, and some of these people, their due date was still, you know, four, five months out, and they asked the question, like, hey, what can we do now to avoid C-sections? And we talked about nutrition. Their providers had never talked to them about nutrition. So please look into some um, we do have some podcast episodes here about nutrition during pregnancy. That's a very neglected um item. Another thing to do, and this is early labor, like during labor, is stay at home during early labor, like when it's safe to do so, right? When it's smart. Um, look for any warning signs, of course, but um going to the hospital too early can increase the opportunity you have to be offered and to accept and to be um given interventions, right? So in early labor, eat and drink, um, hydrate yourself well, nourish yourself well, balance yourself between rest and movement, um, be upright, walk, shower, um, employ some nice comfort majors in those early stages when labor is kind of manageable. Um, and so so kind of avoiding going to the hospital until contractions are strong and consistent, till you can't talk through them, until they're coming every three minutes apart if it's your first baby, maybe five minutes apart if it's a second or third baby. They're lasting at least a minute. That's been going on for an hour or more. Um a lot of people get really anxious when labor begins, or the partner gets really anxious, like, hey, we gotta get there, we gotta go. Maybe you don't. Maybe stay at labor, um, stay at home during early labor. Another thing um that will help avoid cesareans is continuous support during labor. So that can be um, you know, we know that research shows consistent support um can lower C-section rates for a lot of reasons. Part of that's emotional, um, part of that's helping you know what's normal and helping you be patient through normal processes. Part of that's incorporating comfort measures, um, movement, movement's huge. So support can come from a really knowledgeable partner who's gonna be with you every step of the way, who's learned with you, who can employ strategies to help you through a long or short labor. That could be a trained doula, um, getting someone who is really, this is their job, right? To help people through the labor process, um, a really supportive nurse. Now we don't know until we get there who our nurse will be. Could change every 12 hours. I was just at a birth earlier today. Um, we had three nurses, three shifts of nurses, one hour with one nurse, 12 hours with the next one, and one hour with the same nurse we had the night before. Um, both nurses were phenomenally supportive of everything. And this client had some pretty specific requests, and the way she communicated those to the nurses got them on her team right away, and they were phenomenal with her. Um, so a supportive nurse. And when your nurse over, like be good to your nurse, appreciate your nurse, get your nurse on your team. Um, and and a mid a supportive midwife like midwifery care is phenomenal for helping. Um, a lot of times midwives will have lower cesarean rates than um OBs do because of their approach, actually. There is one midwife I worked for for many years, and she or I worked with her as a doula for dozens and dozens of births together. And the way she prepared her patients all along through their all their visits during pregnancy was unique. And she took her time with them, she educated them, um, she listened to them, she gave them tips, she gave them confidence, she empowered them all along the way, and she helped them with a lot of these same tips, actually. She liked stay at home during early labor. She gave them confidence in the process, confidence in their bodies. And a lot of times I was with her at three different hospitals in a birth center over the years, and her patients, and the nurses said this a lot, they noticed it. Her patients came in in advanced labor. They came in confident, they came in comfortable. Um, they were well progressed in labor. So they came in, got down to the business of having a baby pretty quickly after they got there. Um, that was just how she kind of led them over the course of their time together during prenatal visits and pregnancies. So that was to me a little snapshot of the potential of a provider and how a provider can prepare patients, um, empower them, and kind of have an impact. Like she had a pretty broad impact on her patients because they would come in in very similar states, confident, empowered, and in advanced labor, ready to have a baby, um, not long after they got there. I'm not talking like imminent birth, but they were oftentimes six, seven, eight centimeters by the time they came. They had the tools. Um, she empowered them with tools to use in early labor and partners as well. So um that can be really important, like uh just how you prepare mentally as well as physically and emotionally. So when you have a supportive partner who's knowledgeable can help, or a midwife or a doula or a supportive nurse, that can actually shorten labors, right? Like um when the body and the brain and the mind and the heart are not nervous, not tensing up, when they can be confident, that can shorten labors, honestly. It can lower the need of interventions, um, it can increase satisfaction with the birth experience, it can decrease cesarean rates. Um so please seek out support. There's lots of different ways to get support. And then one of my favorites is mobility. Protect mobility during labor. Strive for mobility and movement during labor, change positions frequently. Movement helps babies to rotate and descend. Um, one of the biggest reasons that a lot of C-sections are recorded is um well, we got fetal intolerance is quite common. Um, maybe positional like breach or transverse or something, but a lot of times it is what what people call it's my baby got stuck, my baby was too big. Um, but movement sometimes that's that's a little questionable in my mind if we hear a baby's too big. Like pretty rarely are babies too big, but sometimes they're not given the chance to be have the mom's body in positions and to move enough so that the baby can make its way down through the pelvis. So upright positions are awesome. Gravity is your friend, walking is great. It moves that mid-pelvis using a birth ball, um, using a tub, using a shower, that gives you some great um upright positions as well. Being on hands and knees is fabulous. Um, and doing this position during pushing as well, if we're having a longer second stage or longer pushing. Even after if folks get epidurals, sometimes we, I mean, especially after epidurals, we want to focus on position changes. We're not just a beached whale. After you get an epidural, it's really important to continue those movements using upright as much as you can, not out of bed, of course, but upright positions for a little while. Um, some really awesome sideline things with um some exaggerated positions will help that baby rotate and descend. We got to give that baby every chance. We got to help out that baby. Another one I see a lot is people aren't patient with the labor process. This could be providers not being patient. Um, you know, they like want to move things along. Um, they get they're getting nervous about stuff. And yeah, there's signs we want to look for and be smart about. Um, but we know labor can take a while, especially if we're inducing for whatever reason. If we're inducing early, if we're inducing a cervix, it's not super ready or prepared. Yeah, that's gonna take a while. It's gonna take a hot minute. I have had four clients in the last five, actually. Four be induced and one had spontaneous labor at 37 weeks. The four that were induced, it was for different reasons. One's for intrauterine growth restriction, two were for preclampsia, one is for twins, but every single one of them, and then one had spontaneous, just boom, she had a baby at 37 weeks um with no prompting from an induction. But when we're pushing a cervix at 37 weeks, we gotta know it's gonna take a minute. That cervix probably isn't super ready um to do some movement. So be patient. And patients, when patients are patient, um, the provider can be more patient. When the provider's more patient, the patient can be more patient. So I want you to go into inductions, especially early ones, realizing um that it'll take some time. I have honestly, it's not common, but it can be, it can certainly happen. I've had people get induced on a Monday, maybe late at night, um, and have a baby on a Friday. Um, and have a, you know, not a cesarean, but a vaginal delivery. Sometimes it does take a while. And most of that time is spent kind of ramping up, warming things up. So early labor can take longer than we once thought. You know, some of the literature we've seen, or even in books and stuff, the guidelines is that might take 12 hours, you know. Well, sometimes it's 48 hours. Like it can be, it can be a slow process. Um, and also really realizing that um pushing second stage, right, can take a while in and first babies, especially. One hours, two hours, three hours, or more can be normal and change position even with pushing. Um, so as the as you are patient, and a lot of times I see a partner who's not patient, or I see um, you know, they get worried about things. And so if you have someone there to help normalize, yep, yep, this is normal, yep, your baby's doing well, yep, we're gonna be patient, we're gonna give it time, um, and have some things to do, you know, have be prepared for that one-day, two-day, three-day induction process can be helpful. Sometimes it's um the woman herself who's impatient. Um, sometimes it's the provider who's impatient, sometimes it's the nurses who are impatient, sometimes it's the time of day or the um holiday. You wouldn't believe how many people um try to have babies right before a holiday, right? So we're kind of pushing it, we're not being very patient. Um, there's a statistic that's been rolling around for a long time that the most common times for cesareans in the United States are 4 p.m. and 10 p.m. on a Friday. So I wonder, you know, what kind of leads to that. Are we patient as we're going into a weekend? Um, and then sometimes the pressure comes from other family members so often also. And a long, slow, expected labor process or induction process. We've got grandmas or um sisters or family members who are um kind of you know, pestering, texting, calling and saying, why is she still pregnant? I can't believe they're still letting her be pregnant. Well, you know, sometimes things take a while. People need to know that. Um, there are um some things when we know a cesarean's a right choice, right? Placenta previa. Of course we're gonna get a C-section. The placenta is covering the opening, right? The cervix. Baby can't go through that. Um, some fetal distress situations that you know gets a lot of uh C-sections happening, actually. And you know, a little controversial on how accurate that is. Sometimes breach situations or other positions. Um, we don't have a whole lot of doctors in hospital who deliver breach babies. It's kind of a lost art at this point. Complications sometimes during labor for mom's health. Uh seen a lot of preclampsia lately. Um Um sometimes we'd have emergencies that come up like a um placental abruption or a prolapse cord. Um so the placental abruption, the placenta kind of starts coming off the uterus. Um the prolapse cord, the cord kind of comes out before the baby's head. That's why both of those situations are very fast C-sections. So again, C-sections aren't bad, evil, or wicked. They are just super overused. Um and and that's kind of the the current reality that we're living in. Nobody's, you know, out there to to, you know, do a whole lot of damage that way, but that's kind of where we're at, and we could all kind of make a difference in our approaches to kind of lower those. So kind of what I want to empower people is um there are some things you can do to avoid c-sections. As I was teaching childbirth classes in the last few weeks, um, we talked about this. One of my classes had nine couples in it. I'm like, all right. So three of you statistically are gonna have a c-section. And that was pretty disturbing to the class. Um another class had six. I'm like, all right, at least two of you are going to have c-sections. Who's it gonna be, right? And nobody, nobody wanted it. There are some people who do want a c-section, I'd be fine with it. Um, but I want people to know that there are things you can do before and during labor, um, and even as you plan who who and where you're gonna have a baby with that is gonna be helpful as well. So ask the questions, right? Ask questions to providers, build a strong um relationship, strong connection to your birthing team, whoever that is. Um, trust your body, remain flexible to how things go, um, be patient with the process and move. Just move it, move it, move it. There's that cute song from Madagascar, I think, of move it. Um so I want you to take these hopefully empowering tips into your birth process, your labor process. If you're early on in your pregnancy, there's a lot you can do ahead of that. Um and kind of enjoy your journey as well. Make sure to enjoy the journey and yeah, some people do have cesareans and we're super glad for them when when they do. They have um improved a lot over the years, and we're so grateful that they are there. So take that info for what it's worth. Hopefully it will help you in some way. Um, this is Angie Rosier signing off from the Ordinary Doolow Podcast, and please take time to connect to someone. Um, human connection is so important. You never know when somebody will need a wink from you, a hug or a quick hand squeeze. Um, but please make a connection with someone. Tell them today that you love them. Hopefully, you'll be back next time. Thanks for being here, and I'll see you soon.

SPEAKER_00 25:05

Episode credits will be in the show notes. Tune in next time as we continue to explore the many aspects of giving birth.