As the delivery date approaches, it becomes a major concern for the mom-to-be whether to have a cesarean or natural birth. There are so many questions that come to mind before delivery. It is a tendency to call experienced friends and family members for suggestions. We hear so many birth stories from them about both the procedures. Many will consider natural birth, others will recommend C-section. Be it any way, your little bundle of joy is coming. But ‘how’ is your personal choice if there is no medical condition. Usually, a woman is given the power to choose how she wants to deliver her baby. Here is when the mind begins to boggle whether to opt for cesarean or natural birth.
Out of 130 million babies born in the world every year, 6-27 percent are born by C-section. Roughly, this is one-fourth are delivered surgically. There are pros and cons to both delivery methods. C-section is also safe but vaginal birth is safer. Be is a cesarean or natural birth, one is not less painful than the other. The safety of the mother and baby should be the only priority. Choose wisely keeping in mind the pros and cons and what suits you better. Talk with your doctor or midwife about what kind of birth will be better for you.
Vaginal Birth or Natural Birth
This is a natural way of delivering a baby where the baby comes out through the natural opening of the vagina which is meant for childbirth. This is the most preferred delivery method. Nevertheless, it is a very painful process. Back then people were hell-bent on normal delivery despite putting baby’s and mother’s health at risk. Now, Doctors, family, and mother-to-be choose what is better for them. Women with low-risk pregnancies are generally advised vaginal birth.
Pros of Vaginal Birth
- Shorter hospital stay – Usually the women who deliver naturally are sent home 24 hours post-delivery. The first 24 hours are crucial to monitor the newborn and mother’s health.
- Faster recovery- Women who give birth naturally have easier and quicker postpartum recovery. Oxytocin helps to increase contraction, it also provides relief by encouraging the release of natural endorphins.
- No-to-few hospital visits post-birth– If everything is okay, there is no need for a post-delivery visit to the doctor.
- Fewer chances of infection– Major surgeries have more chances of infection. As the incision is more prone to bacterias and contamination.
- No scarring – Normal delivery does not require any major surgical procedure, so there is less or no chance of scaring of incision made in cesarean. Under normal delivery, a minor cut is made from the vaginal wall to the perineum to enlarge the opening through which the baby passes. This procedure is known as episiotomy or perineotomy. This is only if required.
- Fewer risks- The risks of blood loss, infections, incisions, etc are lesser in normal birth.
- Lesser medications– You will not need pain relievers unless you had an episiotomy.
- Easier breastfeeding– After a natural birth, breastfeeding is easy. Mothers are conscious and awake in the whole procedure. They can start moving early. So it becomes easier to sit or lie in a comfortable position to breastfeed the baby.
- Satisfaction– Some women find that they feel better after natural birth than artificial methods. They feel they were successful in doing the job they were created to do for by nature. Another reason for this is the release of natural hormones.
- Quicker mother-baby contact– Mothers can hold the baby soon after birth.
- Lesser medical issues in future pregnancies– There are chances of healthy future pregnancies and lesser delivery issues.
- Get back to routine life quickly– New mothers can do the chores on their own in a week.
- Babies born vaginally needs shorter monitoring. These babies have a strong immune system as they tend to collect good bacteria from the placenta.
- Less respiratory problems for babies– When the baby travels through the birth canal, they squeeze water out of their lungs. This strengthens their respiratory system.
- Lower risks of blood transfusion, pneumonia, autism, and neurological disorders. This because the artificial induction of labor and other medicines can lead to autism and other such conditions.
Risks of vaginal birth
- More painful– Both labor and c-section are challenging. They call it labor for a reason because mother-to-be has to work hard during the labor process. It is more painful as the baby is coming out of you.
- The weakening of pelvic muscles– Intense labor weakens pelvic floor muscles causing pelvic organ prolapse or incontinence. such women become prone to urine leakage while sneezing and coughing. Also, they feel tingling pain in the vagina and perineum.
- Risk of birth injuries to babies– A greater risk of birth injuries such as fractures, bruised scalp shoulder dystocia, and oxygen deprivation are there if labor gets longer and complicated or if the baby is large and delivered vaginally.
- Tearing – There are chances of skin tearing when the baby moves through the birth canal. when crowning of the head would typically tear the vagina and perineum skin. Major tearing requires stitches.
- Bowel and sexual problems– Sexual activities and bowel movement can be painful post vaginal delivery.
- Hemorrhoids– Women complain about bloody piles and constipation after normal delivery.
- Psychological trauma– Chances of psychological disorders and trauma are high in natural birth.
Cesarean or C-Section
About 1/3 of babies in the US are born by C-section. C-section is done in case of difficult pregnancies where vaginal birth can pose risk for the mother or baby. It is a surgical procedure in which incisions are made in a women’s abdomen and uterus. During the cesarean, you’ll need to have some form of anesthesia for your surgery. Most women with no complications have regional local anesthesia in the spinal region. The medicines are introduced close to the spinal cord into the cerebrospinal fluid in the subarachnoid space. This causes the entire lower half of the body to feel numb. You will be awake for the whole birth or surgery and can see the baby immediately afterward.
Reasons for a C-section
- Baby is in breech or transverse position
- The Baby’s head is too big to travel through the birth canal
- Baby has developmental conditions
- Prolonged labor or stalled labor
- Mother with high blood pressure and heart disease
- Previous C-section
- You are carrying twins or multiples
- Mother have STDs and other transmittable diseases
- Placenta abruption or placenta previa
- Umbilical cord issues
- falling oxygen levels of the baby
- Elected cesarean
Pros of C-section
Although there are benefits of c-section, this doesn’t means you should go for it unless needed.
- Less pain– Anesthesia makes the lower body numb and reduces the amount of pain during birth.
- Lifesaver– cesarean is a lifesaver when vaginal birth is dangerous for mother, baby, or both. Like in the case of congenital heart disease, the doctor knows soon enough if the newborn needs surgery.
- Lower risks in babies– There are fewer chances of injuries like fractures, lowering oxygen levels, and shoulder dystocia as the baby doesn’t have to bear the physical ordeal while passing through the birth canal.
- No risk of pelvic floor disorder or tearing – Women do not have to push the baby out, so there is no risk of pelvic floor disorder or tearing.
- More convenient experience– you can usually schedule a c-section unless you have an emergency which potentially allows for a more convenient overall experience. Knowing the date of birth in advance gives you time to prepare well.
- Lesser risk of urinary incontinence and pelvic prolapse– pelvic floor muscles get weaken during childbirth making the bladder prone to pain, leakage, infections, and incontinence
- Infection transmission rates are low- If mother has STD or other deadly virus, c-section lessen the risks of passing such conditions from the mother to baby.
- Fewer chances of sexual problems– Women who undergo c-section tend to have less sexual issues as there is no damage done to the vagina, perineum, and uterus.
- Increased risk of blood loss– This may require blood transfusion
- Blood clotting– The risk is higher as you are not moving much
- Higher death rates– Rates of neonatal and maternal death are higher as compared to that in vaginal delivery.
- Respiratory problems in infants– especially if carried out before 39 weeks of pregnancy. Studies show a higher rate of asthma till 12 years of age in the kids born by C-section
- Obese kids– There is an increased risk of obesity in kids born by c-section
- Possible anesthetic reaction– Anaesthesia given during the surgery can cause a severe headache, and at worst, transient nerve damage
- Increased risks of stillbirth– Studies show stillbirths are higher in cesarean delivery as compared to normal birth
- Longer hospital stays- You need to stay for 4-7 days in hospital post-cesarean. This stay is for 1-2 days in vaginal birth.
- Longer recovery period- recovery post-c-section is different for everyone. You may take 6-10 weeks to recover from cesarean blues.
- Weakened uterus and abdominal muscles. Incisions and opening of the abdomen weakens the muscles
- Difficulty in breastfeeding– Mothers are enactive for long period. This and the stitches can make breastfeeding a little difficult in the beginning
- Adhesions– The risk of adhesions can cause later pregnancy problems such as placenta previa. Adhesions are a band of scar tissues that make organs stick to the uterine wall or abdomen.
- Miscarriages in future pregnancies– Miscarriages and placenta previa are the perils linked with having a C-section
- An increased risk for cesarean in future pregnancies- Women who undergo c-section may need subsequent c-section in the future.
- Surgical accidents– It’s major abdominal surgery. There are chances of injury to other organs.
- Injury to baby– Baby may get hurt during surgery.
- Infections– Infections like Endometritis, UTI may occur post-surgery.
- Additional surgeries– Rarely, but mothers may need more surgery like a hysterectomy post-c-section.
- Postpartum depression– due to long longer hospital stays, recovery period, and pain, risks of postpartum depression are higher in c-section
VBAC( Vaginal Birth After Cesarean)
They say “once cesarean, always a cesarean”. This is not true.
VBAC is also called TOLAC ( trial of labor after cesarean). After a cesarean, you need to decide to go for another planned cesarean or vaginal birth after cesarean. This choice will affect you, your child, and later pregnancies. The success rate of VBAC is 70-80 percent.
Educate yourself well on vaginal birth and VBAC because women who are less aware tend to undergo cesarean which could actually have been a vaginal birth.
- Create a birth plan in advance. This will help you know your requirements well. Discuss this birth plan with the doctor.
- Hire a doula if you can afford it. Doulas are known to assist you with pains and positions thereby decreasing the chances of c-section.
- Consult more than one doctor if you are not satisfied.