No matter how hard expectant moms try, labor and delivery rarely go as planned.
Sometimes this results in emergency C-sections, but a growing number of moms who say the rate of C-sections has risen dramatically, sometimes with dangerous complications.
Mother of two Jennifer Rusch says the birth of her first son Caleb didn't go as planned.
"Eventually I was in a situation where I was having a caesarean section that I probably didn't need if I made decisions differently earlier in my labor," she said.
Rusch says even though she made the best choice with the information at hand, she and Caleb had some negative complications.
"The effects were I couldn't hold my baby right after birth, in fact it took about 8 hours before I could hold him without help," she said. "He had a lot of upper respiratory issues in his first year."
The experience caused Rusch to help form a northeast Iowa chapter of "International Caesarean Awareness Network" or ICAN.
She wants more mothers to know the risks of C-sections and possible ways to avoid them.
Dr. Susan Lipinski at Covenant Medical Center in Waterloo confirms there have been an increase nationally in C-sections in the last few decades.
Some states have a rate as high as 38 percent. Iowa sits at 30 percent, although Covenant Medical Center's rate is 24 percent.
Lipinski says more women are getting C-sections with their first child, and it creates a kind of domino effect, leading to more C-sections.
One of the main reasons behind a cesarean birth: obesity and its related diseases like pre-eclampsia, which raises a mother's blood pressure, and diabetes.
"As we see more and more folks who are overweight and obese, we are seeing much higher rates of these diseases," she said.
Dr. Lipinski also says many women simply want to plan ahead, and therefore plan to be induced.
"Folks don't want to wait till their due date, not knowing when to get child care, they want to tell the family when to come, there are a lot of elective inductions done," she said.
She says mothers have the right to request a C-section, as long as they understand the possible risks.
"Babies born after labor typically do better than babies born in C-sections," she said. "C-section is a serious abdominal surgery that has potential risks, potential for large blood loss and potential for complications."
Doctors say most surgeries go well, but with an increase in C-sections, there is also an increase in mothers dying, especially with successive surgeries because of scar complications and tearing.
"The first C-section is not always the risky one, it's the second, third, fourth down the road that we keep escalating risks to moms," Lipinski said.
There are options for women like Jennifer Rusch who first had a C-section.
She said she researched a great deal and decided to deliver second son Adrian by VBAC, or vaginal birth after cesarean.
"We're doing far too many C-sections and we really, as women, need to be advocates for ourselves and ask the right questions so we can make informed choices," Rusch said.
The birth went well, and Rusch wants to help other expectant moms understand their options so their baby's birth leaves mom and baby as healthy as possible.
The World Health Organization recommends C-sections stay within 10 to 15 percent of births.
So what can mothers do to best prepare for labor? well, it starts before getting pregnant.
Doctors say when planning a pregnancy, get as close to your ideal weight as you can reasonably achieve.
The northeast Iowa chapter of the International Cesarean Awareness Network meets at Sartori Hospital in Cedar Falls on the 4th Tuesday evening of each month and provides free childcare.