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When it comes to having babies there’s a wealth of information out there and a whole bunch of opinions. Most mums are well-educated these days and quite capable of making informed decisions about how they’d like to give birth. But each option has its risks as well as its benefits.

Read on to find out the pros and cons of vaginal delivery and caesarean birth, and why you should be well informed about your options.

Natural birth

Natural birth, also known as vaginal birth, is the process of delivering a baby through the birth canal without the use of medical interventions such as those used in a caesarean section. It typically involves the onset of labour, dilation of the cervix and the baby’s descent through the birth canal, culminating in the delivery of the infant through the mother’s vaginal opening.

A vaginal delivery of a baby is the way women were designed to give birth. Hence the term “natural birth”. The female anatomy is designed to house, nurture and deliver a baby. Women’s hips are naturally wider and pelvises are flatter and wider than men to allow for the baby to pass through the birth canal. The uterus has muscles specialised to push the baby out.

Pros

Being squeezed through the birth canal seems to “kickstart” a baby in some mysterious way. It particularly improves their chances of being able to breathe normally after birth. Not only that but the birth canal journey also covers the baby with immune-strengthening bacteria. This helps a newborn’s immune function and gut microbiome health.

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For the mum, there’s some evidence that contractions prompt the production of breast milk. There’s an incredible design built into the natural birthing process, not all of which is fully understood.

When a baby is delivered naturally, (considering all is well) the baby is immediately placed in the mother’s arms allowing for skin-to-skin contact. Often when a baby is born in an operating theatre via emergency or elective caesarean, it can take several minutes before skin-to-skin contact happens.

There is evidence to show that skin-to-skin contact is important for relational bonding, calming mother and baby. It also assists in regulating the baby’s heartbeat and breathing, helping the baby adapt to life outside the womb.

This skin-to-skin contact also increases levels of the bonding hormone, oxytocin, in mother and baby, which is highly beneficial to both. For mothers, it helps reduce postpartum pain and excessive bleeding, and aids with breastfeeding by releasing milk flow. For babies, oxytocin helps them thrive, grow and develop.

Other benefits of a vaginal birth include less time in hospital, less need for pain relief medication and less need to return to hospital in the coming weeks due to complications. The recovery time is much quicker. This means mums are able to return home to enjoy normal life with their family sooner.

Cons

Delivering a baby naturally can end in an emergency caesarean if the baby is in the wrong position or stuck. This can cause stress on mother and baby and result in things being rushed. This can in turn cause anxiety to run high, leading to a traumatic birthing experience for mum and bub.

Natural birthing can also involve tearing to the vagina, which is very painful and involves extensive rest and recovery time.

Giving birth naturally may not be the safest option if there are pre-existing health problems or if the pregnancy is termed “high risk”. This can be due to autoimmune conditions, heart or thyroid conditions, obesity, diabetes, high blood pressure or cancer. Multiple babies such as twins or triplets can also make a pregnancy high risk.

A natural birth is not predictable and works on your body’s schedule. This may not be suitable in some circumstances and therefore a healthcare team may propose a C-section as the safest option.

Caesarean delivery

A caesarean section, or C-section, is about as medicalised as a birth can be. It is essentially a surgical procedure. The body’s instincts—the baby turning, the cervix opening, the mother’s urge to push—are not part of the process. Instead, the birth becomes an abdominal operation—typically a 10cm horizontal cut just above the pubic area through which the baby and placenta are delivered.

Usually, the operation is performed under local anaesthetic; that is, the mum is awake but is numb from the chest down. This regional anaesthesia allows for the mother to be awake and present during the surgery awaiting the arrival of her baby. In some cases, a general anaesthetic will be used if it is an emergency caesarean birth or the spinal block hasn’t worked.

Pros

A C-section is the way to go when there are serious complications that pose a life-threatening risk to mother or baby. An elective caesarean section can be scheduled for known complications or multiple births. This allows the family to plan and have things ready, which can help reduce anxiety.

Another amazing advantage of having a C-section is that it can save the life of mother and baby. Sometimes serious complications occur late in pregnancy or during labour that necessitate an unscheduled emergency C-section. For example, when the baby is in a breech (feet or bottom-first) position and can’t be turned, when there has been a uterine rupture, or when the umbilical cord is compressed or has prolapsed. A C-section is the only safe option in these cases.

Cons

There are a few downsides to having a C-section, with pain and risk of infection being high on the list. When a mother has a C-section, there will be an abdominal and uterine incision. As with all surgeries, there is a risk of infection, heavy bleeding, complications from blood clots and pain.

The first 24 hours after a C-section are the hardest. Pain levels are high and it’s difficult to move around. Many are also drowsy from the anaesthesia and pain medication.

An operating theatre is also a busy place. There is usually at least 11 healthcare professionals present. This includes a doctor or obstetrician, surgeon and assistant surgeon, an anaesthetist, midwives and theatre nurses. Each of them have a specific role to help ensure mum and baby are safe.

A C-section also only allows for one birth partner to accompany mum in the theatre.

Following a caesarean birth, the mother will go to the recovery room for a few hours. This means being separated from the baby. Birthing is a very emotional time for mothers and being separated from your newborn doesn’t help with that.

A caesarean is a major medical procedure. This means a longer hospital stay after giving birth is typical. Mums who have undergone C-sections will need a good support network for assistance. She cannot lift anything heavier than her baby for six weeks or drive for the same time. She also needs to care for the abdominal wound to avoid it re-opening or becoming infected.

C-sections can also put future pregnancies at risk if there is damage to the uterus during a caesarean. Placenta accreta and low-lying placenta can also occur due to a previous caesarean section, which can interfere with future healthy pregnancies.

A previous C-section also complicates attempts to have subsequent vaginal births. Many medical professionals will not attempt a vaginal birth after a previous C-section.

What should I do?

Should you deliver your baby via caesarean section? Every pregnancy and birth is different and involves some level of risk so it’s something that needs to be discussed with your doctor, healthcare providers and the people closest to you.

Listen to a range of opinions but make sure you get the facts. Your options may be limited if there are medical complications, so focus on the benefit your choice will have on your health and that of your baby.

The best advice for good pregnancy and delivery outcomes is for mum and dad to be in great health at least one year before trying to conceive, to avoid complications and unplanned caesarean births.

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