C-sections vs natural birth, vaginal birth, and more!

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When it comes to giving birth, there are a few different options, but at the end of the day we all want to get the baby out! Ask almost any group of mothers about how they delivered their babies, and you’ll get a mix of babies born via a variety of ways.

You should talk with your doctor about which one is right for you personally or medically. If you’re pregnant and trying to decide between a natural birth (aka vaginal delivery without medical intervention) or cesarean delivery, there are some key differences to consider.

This article reviews the benefits and risks of birthing options, including natural childbirth, vaginal birth, cesarean section (C-section), unassisted delivery, and more!

What is a vaginal birth?

During a vaginal delivery, the baby is born through the mother’s vagina. Uterine contractions help the baby make his or her way down and out of the birth canal.

Labor can last anywhere from a few hours to a day or more. Typically, the longer and stronger your contractions are, the faster the delivery will be.

What is a natural birth?

Natural childbirth is usually considered to be a natural delivery without any medical interventions (like inducing labor, cesarean section, forceps), with just medication for pain relief.

For some women, this is their preferred method because it tends to be less invasive and takes more of a traditional look at the process. Women who want to have a natural birth often want to avoid cesarean sections, too.

What is a cesarean section?

During c-section or cesarean delivery, an incision is made in the abdominal wall and uterus. The doctor then delivers the baby through this incision.

Some cesarean sections are done for medical reasons, such as if distress is caused or suspected during the pregnancy, (such as growth restriction) if baby is large, or if there’s a problem with the placenta or umbilical cord.

Cesarean sections take longer to recover from because of the incision during delivery, but the short term medical outcomes are not significantly different between planned cesarean and planned vaginal births.

What is a maternal assisted cesarean section?

Maternal assisted cesarean section is when the mother assists in delivering her own baby. This method is largely considered a hybrid of cesarean and natural birth that allows for more harmonious transition to postnatal life because the mother is able to take more ownership over the birth of their child.

During a maternal assisted cesarean section, an obstetrician will make all of the required incisions and begin to free baby. When it is safe and appropriate to do so, the curtain between mother and baby is lowered, and she reaches down to help pull baby out.

What is a vaginal birth after cesarean? (VBAC)

If you’ve had c-section in the past, you can usually opt for a vaginal birth (VBAC) next time around.

Before opting to attempt a VBAC, make sure you and your obstetrician discuss all the risks and benefits of VBAC versus cesarean section delivery, given your specific circumstances.

VBAC birth attempts do come with risks, and your chances increase with each c-section you have. Many VBAC attempts still end in a birth via c-section, but there are plenty of examples of successful VBAC births, even after a number of cesarean sections in previous pregnancies. Vaginal births after multiple sections are usually referred to as VBA2C and VBA3C and so on, where the number refers to the number of prior cesareans prior.

What is an elective cesarean section?

An elective cesarean section is a c-section done on maternal request, or cesarean delivery scheduled for medical reasons in an attempt to deliver baby before any know complications arise.

The attending medical team in the theatre are ‘booked’ in advance, and often meet with the mother prior to birth. The surgery begins prior to labor – as soon as labor starts it is automatically considered an emergency cesarean.

What is an emergency cesarean section?

An emergency cesarean is where the intent was to deliver baby vaginally, but mom or baby are in distress and a c-section is deemed the safest way to give birth.

It is not pre-planned (though it may have been discussed) and the medical team who will attend in theatre will be assembled from staff who are rostered on at the time. From when a decision is made, a baby can be born very quickly; often within minutes of the first incision.

What is an elective repeat cesarean section? (ERCS)

Elective repeat cesarean births are cesareans that are scheduled before labor begins based on medical need. (physical or psychological)

ERCS cesareans are scheduled by an obstetrician prior to labor starting, and both the doctor and mother know in advance this is what they will plan for. This allows the hospital to call upon all necessary staff (OB/GYN and the cesarean section team) to be on hand. They are often recommended to mothers whose previous c-section birth was medically necessary.

Is a cesarean section better than a vaginal delivery?

This is ultimately going to come down to individual circumstances. A cesarean is cesarean section (C-section) is major surgery, and is usually done when a vaginal birth would put the health of the mother or baby in danger. This can also include mental health reasons.

Why do women choose cesarean sections?

Some women opt to have cesarean deliveries because they aren’t able to push their babies out due to various reasons (even if they are otherwise considered low risk).

For some women, cesarean deliveries are safer for their babies or themselves for either physical or mental health reasons. Making an early decision from the beginning means mom and her family, and the doctors and midwives who support them can prepare accordingly.

Is C-section or natural birth safer for baby?

Without taking complications in to consideration, neither birth type is better. In some studies, c-section babies have had lower lung function for the first few hours after birth which resolves quickly. Babies born in a repeat c-section may have lower APGAR scores when compared to vaginal deliveries, but again this evens out shortly after birth.

A study on anesthesia during pregnancy suggests no anaesthetic drug has been shown to be clearly dangerous to the human foetus, so even a vaginal birth where a mother us supported by pain medication is considered safe for baby.

The type of anesthesia used during a c-section delivery may also impact a baby’s APGAR score – babies whose mother required a general anaesthetic (where mom is put to sleep) may have a lower score when compared to mothers who have spinal anesthesia. (like a spinal block)

There is also discussion around microbial factors after birth, with suggestions that during a vaginal birth a baby comes in to contact with microbes in the birth canal which are beneficial to their future long term health. (this is where the practice of vaginal seeding comes in to play, for c-section babies.) Skin to skin contact also supports baby’s access to healthy microbiota though, and many obstetricians will facilitate skin to skin contact shortly after c-sections to make the birth process as similar to a vaginal birth as possible.

What are the risks of having a VBAC?

A c-section is major surgery and recovery generally takes longer than a vaginal birth.

There’s a higher risk of uterine rupture if you attempt a VBAC. This is when the incision site from your cesarean delivery opens up causing internal bleeding.

You also have a higher chance of needing another c-section in the future, if something goes wrong during the birth.

Research suggests VBAC deliveries are more likely to require blood transfusions when compared to elective repeat cesarean section births.

What is recovery like after c-sections vs natural birth?

The first poop will still suck.

In fact, the pain killers and other medication that are administered during a c-section may make it more likely that you’ll have interruptions to your digestive system, than after vaginal birth.

C-sections are considered major surgery.

Take it easy and let your body work on healing. Don’t be afraid to ask for support. A c-section is major abdominal surgery and will naturally affect a mother’s ability to do regular daily tasks. Your recovery may also include physiotherapy and/or postpartum massage to help with healing and making sure you do not retain extra fluids through swelling.

Women aren’t allowed to drive after a C-section.

When you’ve had a c-section your core and abdominal muscles will be very tender. It makes braking, steering, and looking behind you very uncomfortable. From a safety point of view, subconsciously you run the risk of hesitating about slamming on the breaks in an emergency because your brain knows it would cause you pain.

It’s not worth the risk.

After my c-sections I was advised I’d be waiting 4-6 weeks before I could drive, but that many women get back behind the wheel earlier than that. It will all come down to your individual circumstances, so speak with your doctor about what is appropriate. You may also need to check any legal requirements in your area before driving again.

You can’t lift anything after your c-section.

My obstetrician and midwives told me that the only thing I could lift is my baby, nothing else.

The general rule is no lifting above your head (and that won’t be possible right away) and nothing heavier than 10lbs. Your obstetrician may recommend the use of a postpartum belly wrap for additional abdominal support.

C-section moms still end up peeing when they sneeze.

Pregnancy puts pressure on the pelvic floor, and just because a baby is born via c-section, doesn’t mean that a woman’s pelvic floor won’t be affected.

Some c-section births were actually attempted vaginal deliveries first, (as is the case with both of my births) and this labor period could have caused stress to a mother’s pelvic floor.

In conclusion

While there are lots of ways a baby can be born, in the end the best way for your baby to be born will be based on you and your baby’s circumstances. To avoid complications, minimize recovery time and get a shorter hospital stay, your obstetrician, midwife, and other medical professionals will be your best source of information.

As a mother you do have a choice for how you want to give birth, but I urge you to trust the advice of your doctor and hospital. Trust in yourself, but also in the team around you – they’ve been through this process many times and will be able to support you and your baby’s needs specifically.

Wishing you all the best, regardless of how you give birth!

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