International Cesarean Awareness Month – Not All C-Sections Are Justified

International Cesarean Awareness Month – Not All C-Sections Are Justified

by Dr. Lakshmi Venkataraman on Apr 1 2019 6:18 PM
Listen to this article


  • Cesarean Section (C-section) Awareness Month observed in April aims to improve mother and child well-being by raising awareness about unnecessary cesareans, as well as encouraging normal vaginal birth after prior cesarean delivery
  • A cesarean section is a surgical procedure where a cut is made on the mother’s belly and uterus to bring out her baby into the world. This operation is typically performed when normal vaginal delivery is thought to be riskier for the mother and/or baby
  • In several countries including the US, the proportion of cesarean sections has steadily gone up in the last few decades that cannot be accounted for rationally. Currently, over 30 percent of deliveries are by C-section compared to about 5 percent in the mid-1960s
International Cesarean Section Awareness Month observed in the month of April. The main aim is to improve mother and child well-being by raising awareness about unnecessary cesareans, as well as encouraging normal vaginal birth after prior cesarean delivery.


Origins of Cesarean Awareness Month & the Cesarean Awareness Ribbon

  • International Cesarean Awareness Network, Inc. (ICAN) was established in 1982 by Esther Booth Zorn along with other women advocating against unnecessary C-sections
  • Initially termed ‘Cesarean Prevention Movement,’ the name was changed to ICAN 1992 to give a more positive ring to the mission statement
  • ICAN has spread its wings and is observed worldwide in the US and several other countries since its inception over 30 years ago
  • ICAN’s chief aim is to improve mother and child well-being by raising awareness about unnecessary cesareans, support maternal recovery following cesarean as well as encouraging normal vaginal birth after prior cesarean delivery


Reason Behind the Cesarean Section Awareness Month Ribbon

  • The burgundy color of the awareness ribbon signifies the blood loss during the process of childbirth
  • Displaying it upside down reflects the helplessness and dilemma women face when their delivery is not in their hands
  • The loop of the ribbon represents the woman’s pregnant belly and the tails of the ribbon signify the woman’s arms


What Does ICAN Do To Help Women Avoid Unwanted Cesarean Deliveries?

  • ICAN volunteers talk to expectant mothers about cesarean sections and give them the necessary information that empowers them to make the right decision and avoid unjustified C-sections
  • ICAN also counsels women who have undergone a previous cesarean delivery and their families and allays their fears and concerns as they prepare for vaginal birth after cesarean (VBAC)
  • The organization interacts with policymakers, administrative officials and health care professionals to advocate the cause of natural birth and avoid unnecessary C-sections

What We Can Do to Raise Cesarean Section Awareness

  • Download cesarean section awareness posters and messages and awareness ribbon from the net and share widely on social media to educate the public about risks and benefits of cesarean section
  • Doctors should provide honest and factual information to patients to enable them to make informed decisions about their birthing choice
  • Both print and visual media should try to improve public awareness about cesarean section by organizing discussions and talks by subject experts

Common Indications for Cesarean Sections & Potential Complications

  • Preterm labor in the mother
  • Fetal distress
  • Maternal health problems such as diabetes, hypertension
  • Short stature of a woman with small pelvis that cannot pass the fetal head
  • Arrest of labor
  • Maternal infections, such as HIV or hepatitis B or C or genital herpes
  • Abnormal position of the baby within the uterus, for ex: breech presentation (feet first rather than the head)
  • Low lying placenta
  • Prolapsed umbilical cord into the vagina ahead of baby’s head
Common complications of cesarean delivery include increased risk of infection, increased risk of blood clots due to prolonged reduced mobility, increased pain and morbidity that takes longer to recover and perhaps a reduced ability to bond with the baby as a result.

Possible Factors That May Contribute To Increased C-Sections

Although the following factors may be cited as reasons for the steep rise in C-sections, the truth is many of these operative deliveries are not medically warranted.
  • Increased maternal obesity and associated risks
  • Increased maternal age at pregnancy
  • Increased incidence of fertility treatments and consequent multiple births
  • Tendency of health professionals to favor C-sections, particularly if there is a history of previous Cesarean delivery

What is Vaginal Birth After Cesarean (VBAC)?

In general, doctors may be reluctant to perform VBACs due to an increased risk of uterine rupture if the previous scar on the uterus tears during labor and is a potentially life-threatening complication. However, the risk of this occurring is very small and less than 1 percent of women opt for VBAC. Also, the risk of uterine rupture reduces with each successive normal delivery following C-section.

Tips To Avoid Unnecessary C-Sections

  • Become aware of cesarean section indications, risks, benefits and make an informed decision
  • Walk regularly throughout pregnancy Opt for a doctor who has low rate of C-sections; learn about the possibility of vaginal breech delivery and VBAC norms
  • Do not have induced labor if there is no indication
  • Have faith and self-belief and positive reinforcement that a natural delivery is possible
  • Join a birth support group and become inspired that natural delivery is the ideal way to deliver for optimal health and well-being of both the mother and baby
  1. April is Cesarean Awareness Month - (