Question

Your best friend is due to give birth in a week and she is agonizing over the decision to take pain medication or go through "natural childbirth". She asks your opinion. What do you discuss with her?

Answer 1

The safety of the mom and the baby is the priority during childbirth. Although vag inal birth is usually preferred (two out of three births are v aginal), if a va ginal birth is unduly risky for a medical reason, the health care provider may discuss a C-section with parents.

• C-section may be recommended if the parents are expecting multiple births, such as twins, or the mom has a condition such as diabetes, high blood pressure, HIV or active herpes.
• C-section may be recommended if baby is not in a head-down position and efforts to reposition it have been unsuccessful.
• Parents may opt for a C-section if they want to plan when the baby is delivered or mom had a previous va ginal delivery that ran into medical complications.

C-section may be prompted by a medical emergency such as when there is a threat to the life of the baby or the mother. Examples of this are if baby is not getting enough oxygen or if the labor is not progressing.

Risks of C-section

It’s important to note that C-section does have risks. It is a major surgery that involves making a cut (incision) in the pregnant woman’s abdomen and removing the baby from the uterus.

When a mother has a C-section for her first birth, her desires and plans for her subsequent births have to be discussed with her provider.

Advantages of Va ginal Birth for Mom

Birth is a normal, physiological process.

An advantage to a vagi nal delivery is that the recovery and the hospital stay after a va ginal birth is typically shorter than after a C-section. For a vagi nal birth, the hospital stay is typically 24 to 48 hours. For a C-section, the stay can be up to four days.

After a vagi nal birth, mom is usually able to hold her baby and start nursing sooner after delivery.

Disadvantages of V aginal Birth for Mom

During vag inal delivery, skin and tissue around the v agina will stretch and may tear as the baby moves down through birth canal. If tearing occurs, mom may need stitches. Without stitches, the tearing can negatively affect urine and bowel function which happens more frequently after vagi nal birth.

A vag inal birth may leave mom with some pain in the perineum — the area between the va gina and anus.

Effects of Vag inal Delivery on Baby

Mom and baby will be able to have contact with one another sooner after vaginal birth. Skin to skin contact and breastfeeding typically can both start sooner after delivery than with a C-section.

A vagin al birth can help squeeze fluid out of baby’s lungs. This reduces the incidence of breathing problems for baby.

During va ginal birth, baby receives a helpful dose of good bacteria. This helps boost baby’s immune system and protects the intestinal tract.

A potential but rare downside of va ginal birth is that the baby (especially if large) may experience injury such as temporary bruising to the head or a fractured collarbone during delivery.

Advantages of C-section for Mom

The advantages for having a C-section are limited. One benefit is that the birth can be scheduled in advance allowing for time to be controlled and predictable.

Disadvantages of C-section for Mom

After the first C-section, the likelihood of a repeat C-section will need to be discussed with the health care provider. Some moms attempt a va ginal delivery with their subsequent pregnancies which is called a Trial of Labor after Cesarean.

The hospital stay after C-section is longer than the stay after a v aginal delivery.

Recovery time after a C-section is longer. The risk for discomfort after the birth is greater due to normal and expected surgical pain along the incision and abdominal soreness. These discomforts can last for several months.

There is an increased risk for rupture of the C-section scar during subsequent deliveries and subsequent pregnancies. There is also an increased risk for placental abnormalities.

With a C-section, mom has a higher risk for blood loss and infection. There’s also a higher risk for injury to the bowels or bladder and for blood clots. The risk of the death of the mom due to blood clots, infections and complications from anesthesia is three times greater with a C-section when compared to a vaginal delivery.

C-section moms typically start skin to skin contact and breastfeeding later.

Effects of C-section Delivery on Baby

There is an increased risk of stillbirth associated with C-section.

The risk for breathing problems, such as asthma, is higher which continues from infancy into childhood.

Research has found a possible link between C-section birth and the risk for childhood and adult obesity which may be a result of the higher incidence of C-section among moms who are obese or have pregnancy related diabetes.

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