Unnecessary cesareans take place more often than you may think, particularly if you live in the United States. While some women choose to deliver surgically to avoid the pain of labor or because they want to schedule their baby's arrival around other events, many want to avoid a c-section if at all possible. And there's good reason to think that reserving cesareans for emergency deliveries is the best way to go. After all, it is a major abdominal surgery with all of the difficulties and dangers that go along with that.

Every day, women who did not want this surgery end up having it, even when it is not strictly necessary. Doctors like to perform them, because it covers them in case of any questions by an insurance company. And in the stress and pain of labor, it can be hard to stand up for what you want or even ask intelligent questions. Fortunately, there are some things you can do ahead of time to reduce your chances of delivering surgically.

Take Care of Yourself

Maintaining good nutrition and exercise habits can go far towards keeping you from a cesarean. When your body is healthy, it's more likely to be able to labor successfully. Staying healthy also helps lower your anxiety, which can be a major contributor towards a c-section.

Make sure you practice your Kegel exercises during pregnancy. These will strengthen the muscles that need to work the hardest during labor. When these muscles are strong, you have a better chance of avoiding a c-section.

Choose Your Doctor Carefully

Some physicians are more likely to do cesareans than others. Talk to yours, and ask specifically what percentage of the births they attend have ended up being cesareans. If it's higher than 15-20%, consider finding another doctor.

Note that it may be difficult to change physicians because of your insurance coverage. If this is the case, you may have to work with a doctor who is more "pro-cesarean" than you would like him to be. If this is you, don't despair! It's still possible for you to have a vaginal birth.

Know Where You Stand

The key to not having a c-section is to do your research. That way, you'll know if the c-section your doctor is proposing is truly medically necessary. This means knowing all about fetal heart rate decelerations (one of the most common causes for emergency cesareans) and other things that can go wrong in labor.

It may be scary to learn about these things, but remember that you're just gathering information. If you get into a situation where a doctor wants to do a c-section, it's important for you to know when they are medically necessary and when they are not.

Avoid Interventions

The more interventions you have during your labor, the more likely you are to have a c-section. This doesn't mean that you shouldn't do something if it will help you or your baby survive or thrive, but it does mean choosing to say "No" when a medical provider suggests something you don't think is necessary or helpful.

In general, you'll have a better chance at a vaginal birth if you avoid being induced, and labor at home as long as you can. Also avoid an epidural, constant monitoring, remaining stationary during labor, and delivery with forceps or a vacuum.

Draw Your Line in the Sand

Well before you're in labor, decide when you're willing to have a c-section. Based on your research, decide what scenarios qualify as emergencies to you and keep them in mind when you're in labor. If you are comfortable doing so, let your doctor know about these situations ahead of time so he or she has a heads up before labor begins.

Note that you never HAVE to have a c-section. You can always refuse. While they may require you to sign something saying that you refuse it against the advice of a doctor, they cannot make you have surgery.

Be Prepared to Make Your Case

Prepare yourself to stand firm. It can help to actually rehearse in your head what you want to say to a doctor who proposes surgical delivery. If you've said it before, even if just to yourself, it will be easier to say it when the time comes.

In addition, let anyone else who is going to be in the delivery room know what you want to say and when you want to say it. Enlist their help in holding your ground. You may even want to hire a doula, who will specifically be your advocate with the medical staff.

Ask Questions Before You Agree to Surgery

When you're in labor and a doctor proposes a c-section, you can always ask questions. One key one is, "Am I or my baby in danger of sustaining lasting damage if I don't have a cesarean in the next 10 minutes?" If the answer is yes, you'll know it's an emergency. If they say no or avoid answering you directly, you'll know that you have a little bit of time.

It can also help to ask for a little more time. If the danger isn't immediate, tell the doctor that you want to be reassessed in 10 minutes, 20 minutes, or even 30 minutes. That way, you'll be able to see if the problem is going away, or if it's something that needs to be dealt with surgically.

Did you manage to successfully avoid a c-section when a doctor wanted to do one? We'd love to hear your story in the comments!

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