Vaginal or Caesarean (C-section) delivery, which is better?

August 21, 2022

Pregnant women can choose between two methods to deliver their baby: a vaginal delivery or caesarean delivery. Regardless of choice, our goal is to ultimately ensure the mother gives birth to the baby in the safest way possible.

Are there differences between the two delivery methods, and is one better than the other? Let’s find out.

Reasons for deciding between a vaginal birth and C-section

Some women prefer to give birth vaginally because it feels like more of a natural experience. Typically, vaginal births come with quicker recovery times, shorter hospital stays and lower injection rates. Some women require no medical intervention during the process, while others need some help of labour management like:

  • Pitocin to induce labour
  • An amniotomy to artificially rupture the amniotic membranes
  • An episiotomy, where an incision is made between the vaginal opening and anus to allow the baby to pass through
  • A forceps delivery or vacuum extraction to help the baby out of the birth canal

When other medical conditions exist that make vaginal delivery too risky, a C-section may be planned instead. A C-section is a surgical procedure to remove the baby from the mother’s stomach. Certain situations make a C-section necessary, such as:

  • Being pregnant with twins or multiples
  • Medical conditions like diabetes or high blood pressure
  • Infections that can be passed down to the baby during a vaginal birth, such as HIV or genital herpes
  • Baby is too large; mother has a small pelvis
  • Baby not in a heads down position
  • Labour happening too slowly
  • Mother and/or child’s health is in jeopardy

Of course, some C-sections are planned for elective reasons, meaning they are requested by the mother before labour for non-medical reasons. However, do keep in mind that C-sections carry additional risks; and C-sections for first-time mothers often lead to future C-sections.

A picture of a fetal monitor machine

What is the procedure for each type of birth?

Vaginal delivery

Women who opt for vaginal delivery can expect to move through three phases of labour. During these phases, you’ll experience contractions, and a nurse or doctor will periodically measure your cervix to monitor which stage you’re at. During which, you may also receive pain medicine such as an epidural to manage labour pain.

Once your cervix has fully dilated at 10cm, you’re ready to push. Your medical team will be by your side assisting you as you push. Once the baby is delivered, expect to still have minor contractions as the placenta is delivered.

Cesarean delivery

A C-section is rather different from a vaginal delivery. First, women with planned C-sections most likely won’t even go into labour since they’ll know the date. Next, while a vaginal delivery can take hours, a C-section takes about 45 minutes.

Before making an incision through the abdomen and uterus to remove the baby, an epidural or spinal block is administered to numb you from the waist down, so you will not feel any pain. Alternatively, general anaesthesia to put you to sleep throughout the entire procedure can also be offered.

 

What’s the healing process like?

A recovery time of 6 weeks following delivery is recommended regardless of birth method. With that said, the recovery time for a vaginal birth is significantly faster than a C-section. In most cases, mothers who delivered vaginally without an episiotomy felt better in 3 weeks or less; those with an episiotomy took the full 6 weeks. Regardless, most will experience perineal soreness and bleeding for 1 to 2 weeks.

Recovery from a C-section involves inpatient stay for the first 2 to 4 days, as moving around can be quite difficult and painful. There may also be mild bleeding or cramping for about 4 to 6 weeks.

However, every birth is different and recovery tends to get easier with subsequent births.

Pros of vaginal birth

  • Shorter hospital stay and recovery time (between 24-48 hours)
  • Avoid associated risks with major surgery, such as bleeding, infections, scarring and reactions to anaesthesia
  • May begin breastfeeding sooner
  • Babies receive an early dose of good bacteria as they travel through birth canal

Cons of vaginal birth

  • Long and physically gruelling process
  • Tissues around the vagina may stretch and tear
  • May experience an organ prolapse or issues with bladder control

Pros of C-section

  • Birth can be scheduled in advance; more convenient and predictable
  • Can be life saving in some situations

Cons of C-section

  • Longer hospital stay and recovery
  • Increased risk for more physical complaints, such as pain or an infection at the site of the incision
  • Greater risk of blood loss and blood clots
  • Increased risk of future pregnancy complications, like placental abnormalities and uterine rupture

Conclusion

As you can see, each birth method comes with its own set of pros and cons. The type of delivery method that’s best for you and your child is the one that carries the least risk. The end goal is to always deliver a healthy baby. If you have any questions or need help in creating a birth plan, make sure to speak to your doctor during your prenatal visits.

Do you have a question for me?

I am more than happy to answer them at enquiry@pkwomensclinic.com and +65 6636 9909.

References

  1. Jansen, C., de Mooij, Y. M., Blomaard, C. M., Derks, J. B., van Leeuwen, E., Limpens, J., Schuit, E., Mol, B. W., & Pajkrt, E. (2019). Vaginal delivery in women with a low-lying placenta: a systematic review and meta-analysis. BJOG : an international journal of obstetrics and gynaecology126(9), 1118–1126. https://doi.org/10.1111/1471-0528.15622
  2. Schantz, C., de Loenzien, M., Goyet, S., Ravit, M., Dancoisne, A., & Dumont, A. (2019). How is women’s demand for caesarean section measured? A systematic literature review. PloS one14(3), e0213352. https://doi.org/10.1371/journal.pone.0213352

 

This article was written and medically reviewed by Dr Tan Poh Kok (PK Tan), a Senior Consultant Obstetrician and Gynaecologist at PK Women’s Specialist Clinic.

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