QuestionMy husband and I are about to start trying to have a baby. I was just curious if there was any way to know if I would have to have a C-section. I really want a normal, vaginal delivery, but I am very small and take after my mother. She had to have 2 C-sections and had so much scar tissue that she never could conceive a third baby. I have a very small frame and have minimal scoliosis, I don't think my gyno could even tell. Everything looked healthy and normal to her, so is it possible to know without looking at my cervix? Or does it just depend on the baby's size? Thanks!
AnswerBarring medical problems such as deformities in the baby, placenta previa, or pre-eclampsia, the most likely reason for a woman to wind up with a c-section during labor is positioning. Do some research on optimal fetal positioning, and investigate different positions you can assume during labor and delivery. Even small-framed women, like yourself, can deliver very large (10+ pound) babies if positioning is right.
First, this means the baby should ideally be in the anterior position, which can be encouraged by your posture and exercise during the last trimester. The anterior position allows the crown of the baby's head to present at the cervix. This part of the baby's head is flexible, with lots of joints that allow the bones of the skull to move, bend, and even overlap, making the size of the head small enough to pass through. If the baby is in the posterior position, the top of the head or even the forehead will present, without this ability to mold and squish, possibly leading to the baby getting stuck.
Second, this means you must remain mobile, active, and not interfered with during labor and delivery. If you are forced to remain in bed, prevented from walking, or forced to deliver on your back, your pelvis will be constricted by this position and your baby will be less able to work with gravity to navigate through your pelvis. Ideally, you want to be on hands-and-knees or in an upright squat for delivery, as this position will maximize the width of your pelvis and shorten the birth canal, easing the passage of the baby.
While there is nothing stopping you from practicing optimal fetal positioning during your third trimester, what you are able to do during labor depends a lot on your care provider. Your safest bet, barring medical complications, is to work with a midwife. Midwives are trained in natural, physiological birth, and are more likely to work with you to avoid a c-section.
Congratulations on your new baby, and good luck!
