Unnecessary c-sections dis-empower the mother, often times making mothers feel victimized. They also get in the way to a successful start to breastfeeding since mother and baby cannot spend time together right away, and a painful incision site makes it difficult to hold baby while feeding.

My only advice to mothers in Miami (and elsewhere) looking to avoid an unnecessary c-section is to do your research on your care provider – if you are delivering in a hospital with a 70% c-section rate, then chances are good you will deliver via c-section. If a natural delivery is important to you, look for a midwife or an OB that practices the midwifery model of care with fewer medical interventions. I’ve also seen a study that showed having a doula attend your birth lowers your risk of a c-section by half.

Interestingly, nearly one year ago, Miami Dade College shut down the only non-nurse direct entry midwifery program at the college level in the United States. (Miami Dade College is also the largest school of higher ed in the country.) The students in the program were allowed to continue, but those that were accepted for that fall, were left out to dry.

Those prospective students, midwives, and friends rallied and wrote letters to legislators, media, and organizations, garnering international support, however Miami Dade College President Eduardo Padron, and the 8 Board Members only had excuses and weren’t interested in any of the solutions that were offered. Even the fact about the C-section and infant mortality rates being abysmal and the fact that Gov. Charlie Crist had signed onto measures to combat this–nothing was offered to the students or to support the program. Not one single glimmer of hope.

And now look.

More interestingly is that Jennie Joseph, owner of the Birth Place in the Winter Garden area of Orlando, FL, has been successfully attending pregnant women for quite some time. And NOW, drum-roll please…–a Certfied Nurse-Midwive pilot practice in the area has been implemented to copy her results–giving CPMs like Jennie, no credit.

The CNM-CPM-and medical establishment debate continues….while women and babies are dying.

They know what to do in Florida, they just aren’t doing it. It’s really that simple.

Some people think it has something to do with Hispanic ethnicity. Other than Brazil, I am not sure if other Latin American countries have high rates of cesareans. And, this kind of complaint implies that it is maternal demand that is driving the cesarean rate, and I think most literature in general contradicts that maternal demand is that high. But, many practitioners are of Latin descent, also. What that has to do with cesareans, I have no idea.

I think the ob/gyn population here tends to be rather incestuous, with many practitioners coming from the same training program, which has a higher than 50% cesarean rate and a rather overmedicalized reputation. Also, medical standards of care vary from region to region, and trends may seem to feed off of the medicolegal climate.

With the malpractice rates being so high (and the cost of living and standard of living for the ob/gyns who go bare) doctors may need to cram in more office visits and more procedures and may have little time for unscheduled labors.

Miami in general is not an overly progressive or deep city. There isn’t a strong counter culture movement. Not a lot of networking between groups. I didn’t know anyone else who had used a midwife personally when I sought one out.