I know people like to believe C-sections are done because the obstetrician is too lazy to wait for you to be ready to push and that it makes them more money. However, the reality of the situation is that they just want to get your baby out in the safest manner possible. If you have not progressed in active labour for three hours and you're stuck at 5 centimetres, chances are the baby is not coming out naturally.
Sometimes it's risky to wait and see if it happens naturally, because the longer you wait, the more chance there is that the baby will become distressed and their heart rate will begin to drop. If we know the baby is stuck for one reason or another, why wait for him or her to be in danger before getting them out? If there are already signs that the baby is in distress — such as a drop in fetal heart rate — then your time is even more limited. What about a breech baby? Although it is possible to deliver many breech babies vaginally, it is not always the safest route. There are different types of breech: frank breech, complete breech and footling breech. If the baby is a footling breech, a C-section is often recommended.
Along with failure to progress and breech presentation, there are numerous other reasons C-sections are medically necessary: pre-eclampsia, placenta previa, cord prolapse, maternal distress and fetal distress, just to name a few. Remember, the end goal is a healthy baby. How he or she comes out shouldn't matter.
Some of the most beautiful births I have been to were C-sections. The baby still comes out crying, and Mom and Dad can still see the baby and even hold the baby (assuming the baby is well and doesn't need any interventions). If everything went smoothly, then often Mom is calm, pain-free, emotional and ready to see her baby. The bottom line is a baby is still being born, and this in itself is beautiful. It doesn't matter that it came out through an incision in Mom's belly as opposed to her vagina — it's still a miracle.
So you've been in labour for 20 hours, it's 3 a.m., you're at 6 centimetres, and you're so, so tired. Your contractions are now coming so close together that it's even painful between them. You had your heart set on an unmedicated birth, but you haven't slept in over a day and are losing hope. What do you do?
First of all, remember there is no wrong answer. If you think you still have enough juice in you, then go for it. If you don't, then don't beat yourself up, because you will still need an unbelievable amount of strength and energy when it comes time to push. The danger of being too tired to push is that your energy is needed to help get the baby out in a safe, efficient timeline. When the baby is deep down in your birth canal, they essentially get "squished" with every contraction. Your strength is important in pushing out the baby with as few "squishes" as possible. If you don't think you can do it, then get the epidural. This will allow you to rest and recoup before you're needed again. An epidural does not harm the baby, gives you a little relief and rebuilds your energy, so stop feeling guilty. It is the first of many tough decisions you will make for your baby.
As long as you keep this in mind — that a healthy baby is all that matters — there is no wrong course of a delivery. Let go of the guilt, and get your epidural if that's what you want. Enjoy your C-section delivery if that's what's needed. Do what is best for you and your baby — that's the best birth plan of all.
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