5 Evidence-Based Strategies to Support Vaginal Birth & Potentially Avoid Cesarean Sections
By Candace, RN, CLC, and Doula, Compass Doula & Lactation PLLC
Hey there, I’m Candace, the heart behind Compass Doula & Lactation. As a registered nurse, certified lactation counselor, and doula, I’m passionate about empowering families with knowledge and support to make informed choices during their birth journey. Cesarean sections are a vital, life-saving tool in modern obstetrics, often essential for ensuring the safety of both mother and baby. The World Health Organization suggests that cesareans are medically necessary in about 10-15% of births to address complications like fetal distress or maternal health conditions. Yet, with cesarean rates in many countries climbing above 30%, expectant parents often wonder how they can support their chances of a vaginal birth when it’s safe. While cesareans are indispensable when needed, there are evidence-based strategies that can help reduce the likelihood of an unnecessary procedure. Below, I share 5 practical, research-backed approaches to empower you on your path to a vaginal birth, while honoring the critical role of cesareans when they’re necessary.
1. Build a Supportive Birth Team
Your birth team is the foundation of your labor experience. Choosing a care provider, whether an obstetrician or midwife who shares your vision for vaginal birth can set the stage for success. A 2018 study in The Lancet found that midwifery-led care for low-risk pregnancies is linked to lower cesarean rates and higher maternal satisfaction. Adding a doula to your team can further enhance your experience; a 2017 Cochrane review showed that continuous labor support reduces the likelihood of cesarean by offering emotional and physical encouragement. At Compass Doula and Lactation, we’re dedicated to advocating for your preferences while keeping safety first.
Actionable Tip: Early in pregnancy, interview providers to understand their philosophy. Ask, “What’s your cesarean rate for low-risk births?” or “How do you support vaginal delivery?” Pairing with a doula can help you feel confident and supported throughout labor.
2. Invest in Comprehensive Childbirth Education
Knowledge is your superpower during childbirth. Childbirth education classes, like those offered through Lamaze or Hypnobirthing, equip you with tools to navigate labor with confidence. These programs teach techniques such as breathing, visualization, and positioning to manage pain and promote labor progress. A 2016 study in Birth found that women who attended structured childbirth education were more likely to achieve vaginal birth and felt more empowered. Understanding the stages of labor and when interventions like cesareans are truly needed helps you partner with your care team effectively.
Actionable Tip: Sign up for a childbirth education class by your second trimester. Choose programs that cover both vaginal and cesarean births to prepare for any scenario. At Compass Doula and Lactation, we can recommend local or virtual classes tailored to your needs.
3. Encourage Optimal Fetal Positioning
Your baby’s position during labor plays a big role in your chances of vaginal delivery. Babies in the anterior position (head down, facing your back) are better aligned to navigate the birth canal. Techniques like Spinning Babies exercises, including pelvic tilts and side-lying postures, can encourage optimal fetal positioning. A 2020 study in The Journal of Maternal-Fetal & Neonatal Medicine found that specific maternal postures during labor reduced cesarean risk by improving fetal alignment. Working with a provider or doula trained in these techniques can help you feel proactive.
Actionable Tip: In your third trimester, practice daily exercises like forward-leaning inversions (with professional guidance) to encourage your baby into an optimal position. Discuss any concerns about fetal positioning, like breech presentation, with your provider early.
4. Explore Non-Pharmacological Pain Management
Your approach to pain management can shape your labor experience. While epidurals are a valuable option, they can sometimes slow labor or limit mobility, potentially increasing the need for interventions. A 2018 meta-analysis in Obstetrics & Gynecology noted a slight link between epidurals and increased cesarean risk in some cases. Non-pharmacological methods, like hydrotherapy, massage, or acupressure, allow greater movement and can support labor progress while managing discomfort. These tools are about working with your body, not pushing through pain.
Actionable Tip: Talk to your birth team about pain management options. Practice techniques like using a birth ball or warm water showers during pregnancy to find what works for you. Your doula can guide you through these methods during labor.
5. Advocate for Patience in Labor
Every labor unfolds at its own pace, and allowing time for progress, when safe, can reduce the need for interventions. The American College of Obstetricians and Gynecologists (ACOG) notes that prolonged labor doesn’t always require a cesarean, especially without fetal or maternal distress. Practices like intermittent fetal monitoring (when appropriate) and freedom to move during labor can support your body’s natural rhythms. A 2019 study in The American Journal of Obstetrics & Gynecology found that extending the time allowed for labor lowered cesarean rates without compromising safety.
Actionable Tip: Discuss your provider’s approach to labor timelines and interventions. Create a flexible birth plan that prioritizes patience and shared decision-making, and rely on your doula to advocate for your preferences during labor.
Final Thoughts
Cesarean sections are a critical lifeline in childbirth, ensuring safety when complications arise. But for low-risk pregnancies, these 5 strategies, building a supportive team, investing in education, optimizing fetal positioning, exploring pain management options, and advocating for patience can empower you to work toward a vaginal birth when it’s safe and appropriate. At Compass Doula and Lactation, we’re here to guide you with personalized support, from pregnancy through postpartum, to make your birth journey feel informed and confident. Always consult your healthcare provider to ensure any approach aligns with your unique needs.
Ready to plan your birth with confidence? Contact Compass Doula and Lactation for tailored support through pregnancy, birth, and beyond.
With love and support,
Candace Stewart, RN, CLC, and Doula
Compass Doula & Lactation PLLC