As in any medical procedure, there are risks and benefits to be considered when choosing which option is best for you. It’s likely that, if you haven’t already, you will soon find yourself discussing labor delivery options with your physician and, most likely, friends and family, as well. You will probably hear all kinds of information regarding the best delivery option for you. As in most situations, the more research and knowledge you can stockpile for yourself, the easier it will be to feel comfortable with your decision, whatever it may be. Let’s begin at the beginning.
Important First Steps in Choosing the Best Delivery Option for You and Your Baby
- Create a birthing plan that clearly states your wishes and expectations during delivery. Include a Plan A option that reflects your most ideal scenario and also include a Plan B that would be referred to only if your Plan A is not possible.
- Interview your prospective obstetrician, doula, or midwife. Don’t be afraid to ask difficult questions such as their experience with vaginal and Cesarean deliveries and their percentages and success rates of both. If your caretaker reports a significantly higher percentage of Cesarean deliveries, can he or she give you a valid reason why?
A Cesarean delivery is a surgical procedure in which a transverse (horizontal) or vertical incision is made through the abdominal wall upon which the abdominal muscles are separated in order to make a second incision into the wall of the uterus. The baby is then extracted through the uterine wall, the umbilical cord is cut, and the placenta is removed, after which the uterus and abdominal wall is closed with stitches. According to the Cleveland Clinic, most Cesarean deliveries are completed within one hour.
Reasons for Cesarean Deliveries
- Multiple births such as twins or triplets
- Failure for labor to progress
- Fetal distress in which it is deemed unsafe to deliver vaginally
- Baby is too large to be delivered vaginally
- Previous Cesarean birth
- Baby is in a breech or transverse position
- Complications of the placenta
- Complications of the umbilical cord
- Mother has an infection or STD that poses threat to baby if delivered vaginally
- Cesarean is elected by mother
Very often, a physician will deem it necessary to perform a Cesarean (C-section) delivery if he or she feels that there is even a slight risk to the safety of the mother or baby. While Cesareans are generally considered safe and have been successfully performed in operating rooms around the world for generations, there has been a significant increase in the percentage of Cesarean births over the last few decades. Over 30% of deliveries in the United States are Cesarean. This percentage is partly due to an increase in elective Cesareans. Oftentimes women opt for an elective C-section which means that the Cesarean is requested for non-medical reasons. Many others, however, are necessary. If your physician feels that because of a specific condition, it’s wise to opt for a Cesarean delivery then, by all means, consider his recommendation. However, if you feel that you want a second opinion, you are within your rights to ask for one. When making your decision about whether to choose a Cesarean delivery, it’s important to do your research and keep the following points in mind:
Pros of C-Sections
- Convenience – Cesareans can be scheduled in advance.
- In cases where there is a danger posed to mother or baby due to a medical condition, Cesareans are often safer than vaginal deliveries.
Cons of C-Sections
- Longer hospital stays.
- Higher risk for complications.
- Increased risk of pain at an incision site.
- Weakened abdominal muscles.
- Increased risk of blood loss or blood clots.
- Longer recovery (up to two months in some cases.)
- Less likely that the mother/baby pair will begin early breastfeeding.
- Increase in risk of death in comparison to vaginal deliveries.
- Increase in the necessity of subsequent C-Sections.
- Higher risk of complications in future pregnancies.
- Increased risk of problems involving the placenta, especially in subsequent pregnancies.
- Increase in infant breathing issues that extend into childhood, such as asthma.
- Increased possibility that the baby will need to be admitted to NICU (Neo-natal Intensive Care Unit) once she’s been delivered.
- Increased risk of stillbirth.
- Increased risk of the necessity of Cesarean deliveries in future pregnancies.
- Risk of re-hospitalization.
Vaginal deliveries are by far the most common delivery option. They are often referred to as “normal” deliveries and carry with them far fewer risks to both mother and baby than Cesarean delivery. They are the preferred option for delivery and account for 2 of every 3 deliveries in the U.S. (Livescience.com)
While there are relatively few advantages to having an elective C-Section, the pros of a vaginal delivery are many.
Pros of Vaginal Deliveries
- Shorter hospital stay (usually 2 or 3 days.)
- Quicker recovery (often just a few days to a week.)
- Avoidance of inherent risks of surgery such as blood loss, scarring, infections, complications with anesthesia or pain medications.
- Helps to remove or squeeze fluid from baby’s lungs as she journeys through the birth canal.
- Baby accesses beneficial bacteria found in the birth canal that supports immunity.
- More immediate contact between mother and baby.
- Quicker initiation of breastfeeding.
Cons of Vaginal Deliveries
- Longer, more physically demanding delivery.
- Possible vaginal stretching or tearing that may sometimes be alleviated by an episiotomy or stitches.
- Possible weakening of pelvic muscles.
- Possible lingering complications with bowel or urinary incontinence.
- Sore perineum (usually just a few days.)
While there are pros and cons to both types of deliveries, it’s clear that Cesareans carry with them more inherent risks, particularly to mothers and babies who are not considered at risk. That being said, there are a few ways, barring the medical necessity of a Cesarean, to help encourage vaginal deliveries.
Some Ways to Avoid a Cesarean Delivery
- Seek a physician, doula or midwife experienced and inclined toward vaginal deliveries.
- Avoid being induced, if possible.
- Labor at home as long as possible. This lessens the time you will spend in a hospital prior to delivery, thereby protecting yourself against possible unnecessary or otherwise preventable medical interventions.
- Employ the aid of a doula. They usually have lower C-section rates and will often work alongside an obstetrician at your request.
Whether you choose to deliver your baby vaginally or by Cesarean and whether everything goes according to your plan is only part of the equation. Oftentimes our best-laid plans are put asunder by an unforeseen complication. If you wish to have a vaginal delivery or if you are advised to opt for a Cesarean, remember that you must put your baby’s safety first, as well as your own. Do your research and remember that information is power. Each woman should make sure they are as informed and prepared as possible. LiveScience has some very useful information regarding the pros and cons of Cesarean and vaginal deliveries as does the Mayo Clinic. That being said, don’t get too nervous about the options, information, and statistics presented to you. Accept the guidance and experience of others as you explore your options and remember that this is only one of many decisions that you will be making. So, sit back, relax, educate yourself, and then enjoy your pregnancy!