Prevention of the Primary Cesarean Section:
Facts, Myths and Tips
by Vijaya Krishnan

[Editor’s note: This is an excerpt of an article which appears in Midwifery Today, Issue 118, Summer 2016. View other great articles and columns in the table of contents. To read the rest of this article, order your copy of Midwifery Today, Issue 118.]

Not long ago, when a woman conceived and had a healthy pregnancy, she took it for granted that she would give birth naturally, the way nature intended. However, we have come to such a tipping point now that when women give birth naturally at our birth center, relatives and friends are surprised that she had a normal delivery. “Wow,” they say. “It is a miracle that you had a normal delivery!” In India, simply by walking into a hospital during labor and birth, a woman stands a significant chance of having a cesarean. Cesarean rates vary across the country, but recent articles report an unchecked increase in cesarean rates in India. In many private urban hospitals in cities across India, cesarean rates are above 75% ( 2016; Rao 2015). That means two out of three women give birth via major abdominal surgery. What has changed? Is this really necessary? How can we prevent that first (primary) cesarean? What do you as a parent need to be aware of?

Adverse neonatal outcomes have not been associated with the duration of the second stage of labor (pushing stage). … My Tip: Asking your doctor to wait until you feel the urge to bear down, and then giving you at least three hours, and using upright positions like squatting, can prevent unnecessary interventions including a cesarean.

I passionately believe that mothers and fathers deserve accurate information to make good decisions. The latest findings regarding the effects of cesareans come from a mammoth study including two million full-term births over a 35-year period in Denmark, showing that children born by cesarean had a “significantly increased risk” of developing certain chronic disorders (Ringgaard 2014). They showed a 20% greater chance of asthma, a 10% greater chance of juvenile rheumatoid arthritis, a 17% greater chance of leukemia and an over 40% greater chance of developing immune deficiencies, as well as higher chances of systemic connective tissue disorders and inflammatory bowel disease.


Vijaya Krishnan is a certified professional midwife and co-founder/director of Healthy Mother Wellness & Care. She believes that through education, advocacy and practice, we can bring sustainable positive change to current birth practices in India, while using the midwifery model of care.

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