ATLANTA - Skylar Watson-Stepherson says her daughter Stone's birth didn't go the way she'd planned.
"I felt guilty," Watson-Stepherson says. "I tried to do all the right things. I exercised until I was 38 weeks, religiously, I ate right."
The 36-year old Georgia first-time mom made it to 40 weeks, planning on a typical vaginal delivery.
But, at the hospital, things quickly changed.
"My midwife came in and said, 'Oh, you're looking good! It's 6 to 7 cm (dilated),'" Watson-Stepherson remembers. "And, then, literally, like an hour later, she said, 'The doctor looked at your case and the baby is distressed.'"
Alexis Dunn, Watson-Stepherson's certified nurse midwife and an assistant research professor at Emory's Woodruff School of Nursing, says because her baby was showing signs of heart complications, they had to go with a c-section.
"Sometimes when you've done if for a while, you can predict how it's going to go," Dunn says. "You can see signs that this is probably going to go bad. So, rather than wait until it goes bad, they want to go ahead and do it."
Watson-Stepherson says she still knows the surgical delivery was necessary, but she felt rushed by the doctor.
"I think the hard thing for me was they wanted me to make a decision right then and there," she says. "My midwife, thank God for her, because she saw how distressed I was, and she said, 'You know what, everyone just give her a minute. Everyone just leave the room.'"
After talking it over with her husband and family, Watson-Stepherson chose to go ahead with a c-section delivery.
Dunn says women should ask their provider how they'd handle a similar complication.
"But I think if women want to avoid a c-section, you have to realize sometimes they're not avoidable," Dunn says. "Sometimes they're needed."
A recent study found the number of cesarean section births worldwide has doubled since 2000.
In the US, 32% of births are now c-sections, well above the 10-15% of surgical deliveries researchers say are medically necessary.
Dunn says the huge jump in c-sections might be driven, at least in part, by the threat of lawsuits down the road.
"They might opt to do a c-section, because, say we got to a lawsuit," she says. "If you have a bad outcome, and say you have a vaginal birth. The question could then be, why didn't you do a c-section? So, I think sometimes there is a little bit of pressure on some providers."
But surgical delivery comes with risks, too.
Watson-Stepherson says the pain was intense.
"It's just so hard to come home with a new baby and you've had this major surgery," she says. "And you're sore, you can't even climb steps."
Four months out, Stone is a healthy and happy baby.
But Watson Stepherson can't help but wonder, what if?
"I would be remiss to say my care wasn't superb, because it was," she says. "I think going into this next time, I would do a little more research, maybe take a little bit more of a holistic approach."