Vaginal delivery has far fewer risks to both the mother and baby than cesarean delivery.
Vaginal delivery has far fewer risks to both the mother and baby than cesarean delivery.

Each has its own set of positives and negatives. In absence of any contraindications, vaginal birth is a natural way of giving birth, but it is prudent to discuss with your doctor, which is a safer option for you in your current condition. 

Advantages of cesarean delivery:

  • Cesarean is often safer than vaginal delivery in case of the danger posed to the mother or baby due to a medical condition and reduces the death rate and illnesses in the mother and baby.
  • Deliveries can be scheduled according to the convenience of the mother (even for relatives).
  • Elective cesarean delivery has become an easy way out, is efficient, and predictable.
  • Benefits for mothers are that it
    • Provides a modest protective effect against loss of urine control (stress incontinence), later in life.
  • Benefits for babies are that
    • Cesarean delivery is a life-saving operation for them in dangerous situations during the birth process.
    • It reduces mortality and morbidity rates in babies during birth.

Disadvantages of cesarean delivery:

  • Prolonged hospital stays
  • Less likely chances of the early beginning of breastfeeding
  • Higher risks of repeating hospitalizations for both the mother and baby
  • Expensive means of delivery

Risks for mother are that there is

  • A higher risk of blood loss or blood clots.
  • Pain at the surgical incision site.
  • Prolonged recovery period (up to two months sometimes).
  • A higher risk of mother’s death during cesarean delivery than that during vaginal delivery due to uterine scarring.
  • Five times higher illness and death rate during cesarean delivery than during vaginal delivery due to complications such as
    • Bleeding.
    • Sepsis (a life-threatening infection in the body).
    • Thromboembolism (obstruction of the blood vessels due to clot formation).
    • Amniotic fluid embolism (fluid surrounding the baby enters into the mother's bloodstream).
  • A higher risk of placental issues and womb rupture in future pregnancies, which may increase severe illness, complications, and death rate in mothers.
  • A higher risk of the requirement of cesarean delivery in future pregnancies.
  • A weakening of the belly muscles.

Risks for baby:

  • While passing through the normal birth passage, the baby’s contact with the mother’s vaginal germinal flora provides immunity to the baby against certain bacteria.
  • Chances of development of a strong immune system are low in babies born with cesarean delivery, and the risk of asthma, atopic dermatitis (skin allergy), and celiac disease (gluten intolerance) is higher in these children.
  • There is a higher risk of breathing issues such as asthma in babies that may extend up to their childhood.
  • There is a higher possibility of the baby being admitted to a neonatal intensive care unit (NICU) after delivery.
  • There is a higher chance of the baby being born dead (stillbirth).
  • Premature delivery or early-term delivery may carry a significant risk of pulmonary complications in babies, especially in babies born through cesarean delivery without labor.

Benefits of vaginal delivery:

  • There is less risk of blood loss, scarring, infections, and complications related to anesthesia or pain medications
  • Vaginal delivery removes fluids from the baby’s lungs as it passes through the birth passage.
  • Access to beneficial bacteria to the baby while passing through the birth canal may support the baby’s immunity system
  • It allows more immediate contact between the mother and baby.
  • It allows for quicker initiation of breastfeeding.
  • Short hospital stays are usually two- to three days long.
  • Quick recovery is often just within a few days to a week.

Risks of vaginal delivery:

  • The process is longer and more physically demanding for the mother.
  • It may stretch the vagina, or the risk of vaginal tear and internal injuries is higher and may alleviate sometimes by an episiotomy or stitches.
  • Possible risk of complications in the mother such as loss of bowel control and urine control may be lifelong.
  • There is a higher risk of adverse outcomes in a twin delivery.
  • There is a higher risk of moderate-to-severe stress incontinence (urine control) in women who delivered vaginally than those who delivered by cesarean (10% vs 5%).
  • There will be a sore groin area usually just for a few days.
  • There is a possible weakening of the groin muscles.

What does normal delivery mean?

Delivery of a full-term newborn baby (37-42 weeks from the last menses of mother) through the vagina without the use of forceps or vacuum for assistance is called a normal delivery of a baby. It is the most preferred option of delivery in the United States, that is, almost two of every three deliveries are normal.

What does cesarean delivery mean?

Cesarean delivery is a surgical procedure to deliver babies through a horizontal or vertical incision on the mother’s belly. The operation is used almost solely to save the mother and baby’s life. It is also called C-section or cesarean section.

During this surgery, the mother’s belly muscles are separated to make a second cut (incision) on the wall of the womb. Then, the baby is extracted through the womb wall, and the womb and belly are closed with stitches. It is often necessary when a vaginal delivery would put both the baby and mother at risk. 

When will your doctor suggest cesarean delivery?

Vaginal delivery has far fewer risks to both the mother and baby than a cesarean delivery. However, your doctor (obstetrician) may suggest cesarean delivery if 

  • You have twins or triplets in your womb.
  • There is obstructed labor (no further progress in your labor)
  • Your unborn baby is in distress.
  • Your unborn baby is too large to be delivered vaginally.
  • You have previous cesarean deliveries.
  • Your unborn baby is in a lie position or position other than vertex (vertex means the baby’s head is in the uterine mouth).
  • Placenta previa is observed (the placenta of a baby is at the opening of the cervix).
  • There are some complications with the baby’s umbilical cord.
  • You have certain infections or sexually transmitted diseases that have higher chances of passing on to your baby during the vaginal delivery process (human immunodeficiency virus [HIV] or acquired immunodeficiency syndrome [AIDS]).
  • You may have chosen this option by yourself for your convenience.

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Medically Reviewed on 11/17/2020
References
Medscape: https://emedicine.medscape.com/article/83021-overview

Journal of Obstetric Gynaecology Can https://www.jogc.com/article/S1701-2163(16)34982-9/pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597642/

WHO/European region: https://www.euro.who.int/__data/assets/pdf_file/0006/277737/Cesarean-Section-or-Vaginal-Delivery-in-the-21st-Century.pdf?ua=1