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Online tool helps break misconceptions around future pregnancies after a C-section

B.C. has Canada’s highest C-section rate at 37 per cent
FILE - In this Oct. 22, 2011, file photo, a doctor examines a pregnant woman at the district women’s hospital, in Allahabad, in India’s most populous state of Uttar Pradesh. (AP Photo/Rajesh Kumar Singh, File)

As B.C. continues to have the highest C-section rates in all of Canada at 37 per cent, researchers have developed a new awareness program to help families plan for the birth of their next child.

My Next Birth is an interactive tool created by the Provincial Health Authority. While the intention is not to dissuade anyone from having a C-section, but it is meant to teach people about their birthing options.

“What matters most to them when they’re thinking about their next pregnancy? And what are the things they need to think about in order to have a birth experiences that matches their values?” said Sarah Munro, an assistant professor in the Department of Obstetrics and Gynecology at the University of B.C.

Munro said some people who have a C-section with their first child can believe that they need to have one with their next, even though that hasn’t been the recommendation in Canada since before 2006. Repeat C-sections, she added, are a big contributor to why B.C.’s rate is so high.

“Sometimes there are situations where after the first C-section, families have questions that are unanswered,” she said. “Most people plan to have a vaginal birth and after their first baby they don’t understand how that unraveled.”

While there are absolutely situations when C-sections are the better – or sometimes only – option for a family, whether or not someone’s next birth can be a vaginal one depends on why their first was a Ceasarean.

“Was it something that happened during labour? Was it an intervention experience? Or if I had received a different form of care, would that have had an impact?”

If these questions go unanswered, then families may not realize vaginal births are an option going forward.

“It’s something they know already and it can give them a sense of control in the midst of uncertainty.”

There are some factors that can make a vaginal birth a less likely option; a previous or suspected classical Caesarean section (versus a lower segment Caesarean section), previous inverted T or low vertical uterine incision, previous uterine rupture and a previous major uterine reconstruction.

The most important thing, Munro said, is that families should get a choice and that the way their first baby was born is typically not a determining factor in how their next one can be.

And it’s that information that Liz Wilcox, a researcher and mom of two boys, appreciated having.

With her first son, Wilcox had a C-section because he was slightly out of position and her delivery team had trouble finding the baby’s heart beat.

Then, when she began thinking about having another baby, she went to My Next Birth to explore her options. As she went through the interactive tool, one of the things that caught her eye were questions about returning to her regular activities.

“If you already have one baby, when they’re a toddler, it’s really nice to be able to have a vaginal birth after Caesarean the second time around, because then you’re more able to pick up to play with the toddler. With a C-section there’s more restrictions,” she said, adding that the My Next Birth tool helped her be more prepared for conversations with her doctor.

This way, no matter what happened, “they knew that that’s what I wanted with the idea that if it ended up going to a C-section, then at least I would have thought through what I wanted and been able to have my say.”


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