If you're pregnant, you've probably given a lot of thought to how you'd like to give birth. You may be determined to avoid a c-section, if at all possible. Or you may feel vaginal birth isn't right for you, perhaps because you've had a previous c-section, face a difficult delivery due to twins or a breech baby, or fear complications, such as the slight risk of pelvic floor injuries. But whatever way you're leaning, use these tips to make an informed decision, and get the medical support you need.
Discuss your doctor's criteria for c-sections. While dangerous conditions like placenta previa or fetal distress mandate a trip to the O.R., find out what she does about less urgent problems, such as prolonged labor. That will clue you in to your caregiver's approach, since some doctors are quick to advise surgical birth in this situation, and others will try to stimulate contractions with drugs or have you walk around or change positions to see if that helps. To learn more about situations that warrant a c-section, read "Will You Need a Cesarean?".
Talk to other moms. Friends can tip you off to what really goes on in the delivery room, says Anne Lyerly, M.D. "See if they felt their doctor respected their wishes. And if it's a group practice, try to find out as much as you can about women's experiences with the other doctors, since it's possible that one of them might end up handling your delivery."
Check on hospital policies. If you're considering a vaginal birth after cesarean (VBAC), it may not be permitted at medical facilities in your community. Then you'll have to weigh the risks of trying for a vaginal birth, and whether it's worth going to a hospital where that's an option, especially if it means a long drive there while you're in labor. In some areas, VBAC isn't available at all.
Prepare for the possibility of surgical birth. If a planned c-section is advised during your pregnancy, there's plenty of time to investigate the risks and benefits -- or get a second opinion if you disagree with the recommendation. But what if a problem strikes while you're in the throes of labor? Plan ahead with a written list of questions to ask: Is this an emergency or can we wait an hour to make a decision?, What are my other options?, and What are the risks to me and the baby if I don't have surgery? If you aren't comfortable with the responses, remember that you have the right to refuse medical procedures or go to another hospital.