Women's Health

Prolonged labor is a good reason for a cesarean. Some obstetricians charge that epidural painkilling slows the birth process that the mother, feeling no pain, fails to push hard enough to squeeze her baby out. Many anesthesiologists argue that epidurals speed some deliveries by reducing pain’s stress. But Dr. Ezzat Abouleish, professor of anesthesiology and obstetrics and gynecology at the University of Texas Medical School in Houston, says data from England show epidurals don’t affect labor’s duration. Janet O’Driscoll, 36, of Cleveland, says she feels she had an unnecessary C-section. “I was given an epidural. I could not feel the contractions. I could not push. The baby was coming down, but the doctor decided that the baby was too big. So cesarean surgery was performed. The baby weighed 8 pounds, 5 ounces.”
Mrs. O’Driscoll had two more children easily, by vaginal birth -one weighing 7 pounds, 8 ounces, the other 10 pounds, 1/2 ounce. “I think my first baby could have come out with the proper encouragement,” she says.
Despite the campaign to lower the numbers of unnecessary C-sections, many conditions do make them necessary, says Dr. Flamm. For example:
•      Slowed labor -the baby isn’t seen to be progressing down the birth canal.
•      Small pelvic bones -the mother’s frame is too small for baby’s passage. (But normal births have succeeded in hundreds of cases.)
•      Breech birth -when the baby is not coming through headfirst. If the doctor cannot turn the infant from a buttocks-or legs-first position, a C-section may avoid damage to mother and child.
To avoid unnecessary and dangerous birth surgery, first ask the doctor about his or her rate of cesarean deliveries. If the rate exceeds 15 percent, you might do well to look for another physician. Otherwise, you risk having surgery performed at the first sign of even the slightest trouble.
Research shows that if you have a vaginal birth after cesarean surgery, 99 percent of the time your baby should be at least as healthy as if delivered by surgery. And you will be playing the key role in your child’s destiny.
However, if the doctor advises a C-section during your labor because you or the baby are not faring well, your best bet is to follow that advice.
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WOMEN’S HEALTH