C-Section vs Natural Birth: Differences, Risks, Benefits?

There are two methods to deliver your baby: traditional vaginal birth or a C-section. Both methods have their own set of procedures and risks.

In a natural birth, your newborn is delivered through the birth canal: your vagina. The process begins with labour, during which your cervix dilates to allow your baby to pass through. This method is the traditional way of giving birth and involves three stages: labour, delivery of the newborn, and delivery of the placenta. Vaginal births can occur spontaneously or be induced with medical intervention.

A C-section, short for caesarean section, is a surgical procedure. Your baby is delivered through an incision made in your lower belly, through your abdomen and uterus. This method is often planned, either because there are medical reasons that make vaginal delivery risky or for other reasons. 

However, C-sections can also be performed as emergency procedures. This is the case if complications arise during labour. But don’t worry if it happens: it’s a very straightforward procedure that’s over within an hour.

Both methods have evolved with medical science, and nowadays, they are much safer for both you and your baby ¹. The choice between them depends on various factors: your healthcare provider's advice, your health and your pregnancy's progress.

What are the implications of these two birthing methods?

• Labour: A natural birth is a natural process of labour. It can vary in duration and intensity. With a C-section, you don’t go through labour altogether unless the C-section is unplanned and performed in an emergency.

• Pain during delivery: In a vaginal birth, pain is almost unavoidable, though it is managed with pain relief methods. For a C-section, anaesthesia is mandatory (spinal, epidural, or general). This is what prevents you from feeling anything during a c-section. 

• Recovery: Even if there is tearing (or an episiotomy), the recovery process from a vaginal birth is usually quicker. Some women have trouble going to the bathroom for a few days. A caesarean delivery, on the other hand, requires a longer healing period. It usually takes around 6-8 weeks to return to normal, and it involves more restrictions on physical activity.

• Consequences for your baby ²'³: Babies born vaginally are immediately exposed to beneficial bacteria from your birth canal, which gives a natural immunity boost. Natural birth can also reduce the risk of respiratory problems at birth, as it expels fluid from the little lungs. Babies born via C-section are not exposed to these beneficial bacteria, called Bifidobacteria, and do not experience the same lung compression during delivery.

To understand which method suits you best, you can discuss it with your healthcare provider ¹. 

A C-section can be either planned or performed as an emergency ⁴. But what creates these two scenarios?

A planned C-section is also called an elective C-section. It is scheduled in advance and decided between you and your doctor during the pregnancy. Your partner can also be involved. It usually happens when there are known medical reasons that could make your vaginal delivery unsafe or for other reasons. These common reasons include your baby being feet-first (breech position), your placenta covering your cervix (placenta previa), or if you’re having twins, triplets, etc. With a planned C-section, your medical team prepares ahead of time. This procedure can be less stressful for you since the timing and circumstances are controlled. Moreover, your partner and loved ones can also plan to be present and give you the support you need to deliver your baby into the world.

An emergency C-section ⁴  is performed when unexpected complications arise during labour or delivery. This could include situations like your baby's heart rate indicates they are not coping well with labour or if labour is not progressing as it should. Emergency C-sections are often more stressful because they happen suddenly. Recovery from an emergency C-section can also be more challenging because of the urgency and potential complications involved.

Vaginal birth is the natural, most ancient way of delivering your baby. It has several benefits for both you and your newborn.

Usually, you recover faster from a vaginal birth compared to a caesarean delivery. Since vaginal birth does not involve surgery, you can go back to your normal activities sooner. You can expect to stay in the hospital for a shorter period, usually 1-2 days. You may also experience less post-delivery pain, even if you underwent a tear or a short incision on the bottom of your vulva (episiotomy). 

With a vaginal birth, you can have an easier skin-to-skin contact with your newborn. Indeed, your newborn will most likely be immediately put in your arms ¹, as he or she will need less birth care. This immediate contact can help stabilise your newborn’s body temperature, heart rate, and breathing. Early breastfeeding initiation is also beneficial for your milk production. It helps establish a strong mother-child bond between you right from the start.

Babies born through vaginal delivery have a lower risk of respiratory problems compared to those delivered via C-section. During a vaginal birth, your baby's lungs are naturally compressed, which helps expel amniotic fluid and prepares the lungs to breathe air. This natural process reduces the likelihood of respiratory complications.

Moreover, vaginal delivery plays a crucial role in a baby’s immune system and gut health. As your baby passes through the birth canal, they are exposed to your beneficial bacteria. This exposure helps colonise your newborn’s gut with good bacteria called Bifidobacteria, which gives your baby a natural immunity boost.

The latest research suggests that this early microbial exposure can influence your baby's long-term health, reducing the risk of allergies, asthma, and other immune-related conditions. In contrast, babies born via C-section may have delayed exposure to these beneficial bacteria, impacting their immune system development and gut health differently.

Despite being the natural way of giving birth, a vaginal delivery also comes with its own set of risks ¹.

Labour can be a long and tiring process. Sometimes, it can even last up to several hours. If the labour lasts too long, it increases the likelihood of interventions. These interventions can involve the use of forceps or a vacuum to assist delivery or even an emergency C-section if labour does not progress. While it’s perfectly normal if this happens, and most women recover quickly, it can be a bit overwhelming

One of the common concerns with vaginal birth is the risk of perineal tears, where the tissue between your vagina and anus tears during delivery. This can range from minor tears that heal quickly to more severe tears that require stitches and a longer recovery period. However, doctors often take steps to prevent severe tearing, such as performing a small cut made at your vaginal opening (episiotomy).

Vaginal birth can sometimes lead to issues with urinary or faecal incontinence postpartum. This occurs because the muscles and nerves that control your bladder and bowel may be stretched or damaged during delivery. Although most women recover over time, some may experience long-term effects. It’s particularly after a traumatic birth (if your labour latest too long, or your baby has to be helped out with forceps or a vacuum, for example) or if you had multiple vaginal deliveries.

Giving birth is a beautiful and transformative experience, but it can also be physically intense. It’s important to thoughtfully consider it with your healthcare provider and ask for advice based on your personal history to choose your birth plan. 

Did your doctor recommend a C-section? Are you afraid of undergoing an emergency caesarean? Don’t worry, here is what you can expect ⁵.

If you have certain medical conditions or carry a high-risk pregnancy, your doctor will most likely recommend a C-section. If you have conditions like high blood pressure (preeclampsia) or gestational diabetes, your doctor may suggest a C-section to reduce risks during delivery. If you’ve had a previous C-section or other uterine surgeries, you should avoid the strain of labour, as it can lead to complications like uterine rupture.

In situations like placenta previa, where the placenta blocks the cervix, a vaginal birth could lead to dangerous bleeding. A C-section ensures that both you and your baby avoid these risks. The procedure allows for a controlled and planned delivery, which reduces the physical strain and complications that can arise from labour in these situations.

Your doctor may recommend a C-section if there are concerns about your baby’s position or health. For example, if your baby presents themselves feet or bottom first (breech position), a C-section can limit complications. Similarly, if you are expecting twins, triplets, or more, or if your baby is larger than average, the risks during labour can increase, and a C-section provides a safe and quick way to deliver.

Sometimes, a C-section is also advised when there are signs of fetal distress, such as an abnormal heart rate during labour. In these cases, a C-section ensures your baby’s safe arrival and prevents the complications that may arise from prolonged or difficult labour.

An elective C-section bypasses labour pain, as the procedure is performed under anaesthesia. This means you won’t experience contractions or the physical exertion of labour. This can be reassuring if you’re anxious about these aspects. However, it’s important to keep in mind that while labour pain is avoided, you’ll still need time to recover from surgery. The recovery period may take a few weeks, with some post-operative discomfort as your body heals.

During a C-section, the pelvic floor muscles aren’t exposed to the same pressure and strain as they are during vaginal delivery. This means there’s less risk of long-term issues like incontinence or organ prolapse, which can sometimes occur if labour is prolonged or the baby is large. For women with a history of pelvic floor issues, this aspect of a C-section can be reassuring, though it’s not the primary reason for the procedure.

While C-sections are sometimes lifesaving procedures, they also come with their own set of challenges ⁵.

The extended recovery period is one of the most significant drawbacks of a C-section. In a vaginal birth, you can resume normal activities relatively quickly. But recovery from a C-section can take 6-8 weeks or longer. This is because a C-section requires healing your skin and the deeper layers of your abdomen and uterus. You should avoid heavy lifting, intense physical activity, and even driving sometimes during this time! After a C-section, your body needs time to heal correctly.

As with any surgery, C-sections carry risks, like infection, excessive bleeding, and reactions to anaesthesia. Your surgical wound can become infected and lead to complications that may require additional medical treatment. There is also the risk of blood clots forming in your legs (deep vein thrombosis) or lungs (pulmonary embolism). Although this sounds scary, don’t worry: if any complication arises, your medical team will be ready to face them and keep you perfectly safe.

If you had a C-section, you might be at a higher risk for complications in subsequent pregnancies, like uterine rupture, if you attempt a Vaginal Birth After Caesarean (VBAC). Indeed, your scar from the previous C-section can tear open during labour and be a life-threatening situation for both you and your newborn. As a result, you may require repeat C-sections in your future pregnancies.

Because with a C-section, your baby doesn’t pass through your birth canal, they miss out on the natural compression that helps expel fluid from their lungs ⁶. This is why they might have more difficulty breathing immediately after birth. Issues can arise, like transient tachypnea of the newborn (TTN), which is a condition where the baby breathes rapidly due to retained fluid in the lungs.

Moreover, a natural birth exposes your baby to beneficial vaginal bacteria. It gives their little immune system an additional boost because it enriches their gut with Bifidobacteria. With a C-section, your baby also misses out on this bacteria, which impacts their immunity ⁶'⁷.

But there's no reason to stress about it! Your baby can catch up on this right from the start. Ask your healthcare provider how to give your little one the best early care.

For some mothers, a C-section is necessary for medical reasons to ensure the safest possible outcome for both you and your baby. If this is the case for you, rest assured that many aspects of your birth experience will go smoothly, and your healthcare team will provide the support you need every step of the way.

In some cases, a C-section may also be performed for specific circumstances. Regardless of the reason, what truly matters is that both you and your baby are safe and well cared for throughout this important journey.