By Dr. P Saroja
Babies enter this world in one of two ways: a vaginal birth or surgical delivery by caesarean section (C-section). The ultimate goal of both methods is to ensure that the baby and mother are healthy.
- If you are pregnant and trying to decide which option is best for you – a vaginal birth or caesarean delivery – there are some key differences to consider as well as questions you should ask your doctor.
- Each has its own set of pros and cons.
- In the absence of any contraindications, vaginal delivery is a natural way of giving birth, but it is still prudent to discuss with your doctor.
- Less risk of blood loss, scarring, infections and complications related to anaesthesia.
- Vaginal delivery removes fluids from the baby’s lung as it passes through the birth passage.
- The baby gets access to beneficial bacteria while passing through the birth canal, which can support the baby’s immunity system.
- Allows more immediate contact between the mother and baby.
- Allows for quicker initiation of breastfeeding.
- Shorter hospital stay.
- Quick recovery, often just a few days to within a week.
- The process is longer and more physically demanding for the mother.
- May stretch the vagina; the risk of vaginal tear and internal injuries is higher.
- Possible risk of complications in the mother, such as loss of bowel control and urine control, which may be lifelong.
- Higher risk of moderate to severe stress incontinence (urine control) than in caesarean delivery (10% vs 5%).
- Possible weakening of groin muscles.
- If a woman has a long labour or if the baby is large, the baby may get injured during the vaginal birth process itself, resulting in morbidity and mortality to the baby.
- Caesarean is often safer than vaginal delivery in case of dangers posed to the mother or baby due to medical conditions like high BP, diabetes, cardiac problems, etc.
- Can be scheduled according to the convenience of the mother.
- Provides a modest protective effect against loss of urine control later in life and pelvic organ prolapse compared to women who deliver vaginally.
- If the baby or mother is in danger, a caesarean section can be lifesaving.
- Requires longer hospital stay and recovery period is also longer; there may be more pain and discomfort in the abdomen as the skin and nerves surrounding the surgical scar need time to heal.
- Higher risk of post-operative pain or infection.
- Higher risk of blood loss and injuries to the surrounding organs like bowel and bladder.
- Women are three times more likely to get complications during a caesarean delivery than during a vaginal birth due to bleeding, infections and anaesthesia complications.
- Once a woman has had a C-section, she is more likely to have a C-section for future pregnancies, and there may also be a greater risk of future pregnancy complications such as placental abnormalities and uterine rupture.
- Babies born by C-section may be more likely to have breathing problems at birth and even related problems during childhood such as asthma.
- When there is a possibility of giving birth to twins or triplets.
- In case of obstructed labour.
- When the baby is in distress inside the womb.
- If the baby is large.
- Complications in the baby's umbilical cord.
- If you have had a C-section delivery earlier.
- Fault in a baby’s position, that is, breech or oblique lie, placenta previa, i.e., low lying placenta.
- If the mother has a sexually transmitted disease like HIV or herpes.
- If the mother has medical complications like hypertension, diabetes or cardiac problems.
- If you have questions about each type of delivery, make sure to talk to your doctor during your routine prenatal visits. The doctor can help you understand which option is best for you.
- The role of maternity programmes in decision-making is very important.
- Try to attend prenatal classes or virtual programmes like a day-to-day healthy maternity care service before delivery. This can help you and your family understand the pregnancy journey.
- Creating a birth plan that outlines your goals for labour and delivery can help you prepare for childbirth.
In vaginal birth, a major benefit is that the baby is exposed to what is known as ‘Beneficial bacteria’ in the mother’s birth canal. As the baby moves through the birth canal, fluid passes through the baby’s nose and mouth, making its way into the digestive system. This fluid contains the beneficial bacteria, which are known to contribute to building up the baby’s immune system while fighting off harmful bacteria from trying to enter the digestive system at the same time. These beneficial bacteria also play a role in coating the baby’s skin, which does its part to prevent the growth of harmful bacteria externally.
- Vaginally born babies may also have a decreased risk of conditions such as asthma and food allergies. They may have a lower risk of becoming lactose intolerant as they get older.
- Research has shown that babies who are born through C-section are more likely to be hospitalised for conditions such as asthma and immune system disorders.
- Lastly, babies born through vaginal delivery are less likely to suffer from certain respiratory problems such as TTN (transient tachypnoea of the newborn), a condition in which fluid gets trapped in the newborn’s lungs. With vaginal delivery, as the baby passes through the vaginal canal excess fluid is squeezed out from the baby’s lungs.
Although it may be physically demanding on the mother, opting for vaginal birth cuts out the risks associated with a caesarean section.
This article was published in association with Rainbow Children's Hospital.