The topic of choosing vaginal birth vs c-section becomes more and more frequent, as more women are choosing to have an elective c-section.
If you look at c-section and vaginal birth statistics, you’ll see that c-sections are performed in over 30% of births. This statistic includes both medically necessary and elective c-sections.
I know what you’re thinking…Should I risk tearing and complications going the way we are supposed to work? Is it worth the healing time to miss out on the experience of a vaginal birth?
These are incredibly fair questions, and you should educate yourself before making a decision for you and your baby. I wanted to talk to you about the pros and cons of each option so you’ll be empowered to make the decision that fits best within your needs.
But hold your horses for just a sec. Real quick – before we get into the nitty gritty (spoiler alert!): vaginal birth is typically a safer option.
Keep in mind, this isn’t ALWAYS the case. Regardless, if you’ve had a normal pregnancy and don’t have time to read this whole article, know that vaginal birth is typically safer and remains recommended above c-section.
Still have more questions? I’m all yours. Read on, momma!
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Common myths regarding c-section vs vaginal birth
Lemme just dispel a couple of common myths regarding c-sections.
- They are NOT typically safer (for you or for baby).
- They are not easier to heal from than vaginal birth.
- They are NOT necessarily more convenient, or less painful.
- You CAN breastfeed and have skin to skin contact with your baby after a c-section.
I also want to point out that our choices regarding our birth are deeply personal, and there is absolutely nothing wrong with having a c-section.
Some women believe that the pain from a c-section is less than vaginal birth, but you have to remember that a 7-pound baby is coming out of you – it’s going to be a little painful regardless of the highway they take out of mommy land.
With all of that said, there are still many circumstances when considering c-section vs vaginal birth where surgical birth is the safer option.
By the way – if you’re looking for some clear instruction on what to expect during labor and delivery, check out my birthing course Birth It Up! Use the code INSTA to save 10%!
Pros and cons of c-sections
I’ll be the first to tell you that c-sections are not all bad. Like everything in life, there are pros and cons to both vaginal birth and c-sections.
Pros of c-section
People associate a lot of pros (that aren’t accurate) when choosing a c-section vs vaginal birth, so I wanted to share some of the actual benefits of choosing a c-section vs vaginal birth.
- lower risk of birth injuries, such as fractures, oxygen deprivation, and shoulder dystocia. This makes sense since these injuries happen because of difficulty getting through the birth canal. Try to push a watermelon into a mason jar without any collateral damage, and you’ll see what I mean.
- Reduce pain during labor. With the wonders of modern medicine, you have a fighting chance when it comes to pain-free vaginal birth (but that doesn’t always work out). A c-section pretty much guarantees that you aren’t going to feel those intense contractions OR the birthing experience like you do with vaginal birth.
- Minimize the risk of a pelvic floor disorder. This is where your muscles and tissues weaken and cannot support your pelvic organs (uterus, bladder, cervix, rectum, and vagina). When this happens, your organs can drop or press in or out of your vagina.
- No tearing. Although keep in mind – tearing is pretty minimal for MOST new momma’s. You can read more about how to avoid tearing during childbirth here.
- Potentially allow for a more convenient overall experience. A c-section can be scheduled…vaginal birth usually isn’t (except during induction-but you still can’t really predict to the hour that baby is born!).
- Reduce the risk of urinary or fecal incontinence. Your pelvic floor muscles weaken during childbirth, making your bladder a little overactive. An episiotomy (and rarely – tearing) can sometimes extend to your perineum, thus causing fecal incontinence. Keep in mind – one of the BEST ways you can avoid these problems is by strengthening your pelvic floor (try some Kegels!)
Related: Episiotomy vs Tearing
See? It’s understandable why some women think that you’re better off getting a c-section. Those are some pretty good pros.
The risk associated with having a c-section are both short and long term, which is why it’s important to make this decision carefully. Keep in mind, a c-section is major abdominal surgery, so it’s a little more serious and involved than most vaginal births.
Risks associated with having a c-section:
- Increased blood loss (yes – potentially more than with vaginal birth), which may require a blood transfusion.
- Blood clots (because you aren’t moving around)
- Rates of neonatal and maternal death are higher in c-section births (you can read more about that here).
- Greater risk of respiratory problems in your infant
- Possible anesthetic reaction
- Later obesity and asthma in children (check out this study done with 30 million women).
- A greater amount of pain during healing
- Longer healing time
- Risk of adhesions, which can cause later pregnancy complications such as placenta previa (where the placenta partially or totally covers your cervix – this can cause severe bleeding during pregnancy and delivery).
- Make breastfeeding more difficult in the beginning (although still TOTALLY doable).
- Increased the chance of stillbirth or miscarriage in a subsequent pregnancy.
These are some pretty serious drawbacks, and where most women will not experience these problems, some do.
Related: Scheduled C-Section: What to Expect
Pros of vaginal birth
I think the biggest benefit of vaginal birth is the fact that it’s generally safer for you, your baby, and future pregnancies. You can certainly imagine that we’re designed (or have evolved) to give birth this way for a reason.
Whether or not you believe in intelligent design, the fact of the matter is that ladies have been popping them out this way forever. They could do it in a barn or field or around the campfire. You can probably assume doing so in a sterile environment, surrounded by professionals, can be pretty darn safe.
Related: Natural Birth Tips
The other benefits of vaginal birth include:
- Faster recovery times.
- NOT having to go through major surgery; Yay!
- Shorter hospital stay.
- Less scarring and chance of infection.
- The possibility of having an easier time breastfeeding and providing skin to skin contact right away.
Vaginal birth risks
Every birth plan option has good and bad, so here’s the list of vaginal birth risks (the bad).
The most common risks of vaginal birth include:
- A potential weakening of pelvic floor muscles causing pelvic organ prolapse or incontinence
- A greater risk of birth injuries, such as fractures, shoulder dystocia, and oxygen deprivation.
- Heavy bleeding
- More painful labor
When is a C-section recommended?
Although vaginal birth is typically recommended in normal pregnancy and labor, a c-section is certainly the RIGHT option in some situations. Here are a few situations where your medical professional may want to schedule out a c-section.
When birth defects are deemed likely to cause additional risk to mom or babe during vaginal birth.
If your baby has a known birth defect (like a brain or heart disease) your provider may prefer to do a scheduled c-section so that they can get your baby out as quickly as possible. It’s a stressful situation on both mind and body for both of you.
Related: C-section Hospital Bag List
Luckily, your little baby won’t remember it, but his or her body might have trouble with the physical stress if there are any underlying weaknesses within the system.
If you’ve had a c-section with a previous birth and the cut was made vertically (used more often in emergency c-sections).
If you’ve had a c-section (or really ANY surgery on your uterus), your chances for needing a c-section vs vaginal birth increase. VBAC (vaginal birth after c-section) has become more safe and common, but your option for a VBAC depends on the reason for your last c-section, the type of incision you received, and other medical factors.
If you have placenta previa.
This can unfortunately cause a lot of dangerous bleeding during vaginal birth, so it’s generally going to be safer to have a c-section.
When your pregnancy is otherwise deemed high risk.
There are some conditions, such as pre-eclampsia or diabetes, that may make vaginal birth more risky than a c-section.
If you are having multiple babies.
Twins or triplets can be rough to deliver vaginally, so your medical provider may recommend doing a c-section vs vaginal birth if you are growing more than one at a time (even though some moms ROCK vaginal twins births too!).
When you have an infection that might present complications or additional risk of transmitting the illness.
Unfortunately, you CAN pass infections like HIV to your baby during vaginal birth. In these cases, it’s safer to perform a c-section. This isn’t true for all infectious diseases, though. There are some infections (like Group B Strep) that can be passed down to your baby, but DON’T require a c-section.
A quick note on Group B Strep…it’s found in around 25% of healthy adult women, so it’s pretty common. If you’ve tested positive for this, your health provider will probably give you an antibiotic injection. With that injection, your baby has a 1 in 4,000 chance of being born with a Group B Strep Infection (which IS dangerous for your newborn).
Without the injection, your baby’s chances increase to 1 in 200. Yikes!
Why do emergency c-section’s happen?
Emergency c-sections are a reality for some mommas, which is why it’s key to make sure that YOU understand that you may need to be flexible with your birth plan. It’s a good idea to plan for preferences that cover both vaginal and c-section birth in case a c-section has to be performed due to unforeseen events.
Here are some of the common reasons you may need an emergency c-section.
Breech or transverse positioning.
Simply put, your baby is supposed to come out head first. If they don’t, this could require an emergency c-section. If face-first isn’t happening and your baby is trying to come out butt-, shoulders-, or side-first, they can get STUCK.
Some babies just don’t know the rules yet. Forgive me when I say this will not be the first time your little bundle displays a total disregard for the rules.
Obstinate and willful right now is assertive down the road, right?
Keep telling yourself that. For 20 years.
Cord prolapse is SUPER rare, but will definitely require an immediate c-section. Cord prolapse is when your baby’s umbilical cord slips out before your baby. This can restrict the blood flow to your little one, which can be incredibly dangerous.
Related: What Happens in C-Section Recovery
The umbilical is your little one’s pipeline to oxygen. As stressed out as the little guy or girl will be, their heart and head certainly need all the oxygen possible.
If your baby is having difficulty getting enough oxygen for any reason, a c-section may be the next step. This distress can come from some of the reasons we’ve already discussed.
Other situations where an emergency c-section is recommended.
Other reasons can include a longer than normal labor, like placental abruption (when the placenta separates from the uterus early), or a uterine rupture (when the uterine wall tears, allowing the baby into the peritoneal cavity–basically, into the rest of your abdomen, where you typically just keep your guts).
Some of these conditions are super rare, but a few can be more common. Luckily, the more common, the less serious, loosely speaking. Regardless, it’s always good to ask about these serious conditions before it’s time to evict your little tenant.
Prepare a list of the questions you’re most eager to ask during your next prenatal visit. If you’re struggling with knowing what to ask, let me know! I’ve seen it all and heard all the answers.
What is more painful, c-section or vaginal birth?
This is an interesting question and one that I get a lot at the eleventh hour. Many women operate on incorrect information regarding the answer. Because you get numbed-up for a c-section as you would any major operation, it’s naturally assumed that a c-section is NOT going to be as painful as natural childbirth.
The moment of childbirth (and I’m talking THE MOMENT) may be more painful when delivering vaginally, true. But RECOVERY from a c-section typically takes longer and is more painful.
If you’re worried about the pain of childbirth, talk with your doctor about their recommendations for pain management. Plenty of women decide to go the route of getting an epidural, which can be just as painless as a c-section, plus you’ll heal much faster.
If I have a c-section, does that mean that any following births must also be by c-section?
Luckily, no. VBAC’s (vaginal birth after c-section) is becoming increasingly common. In fact, research has shown that between 60 and 80% of women who want a VBAC are successful with it. VBAC’s are also associated with fewer complications than an ELECTIVE repeat c-section.
With that said, not all women are able to have a VBAC – even if their next pregnancy is normal. For example, if your c-section incision was made vertically (which IS sometimes necessary), a VBAC is much more dangerous and can end in uterine rupture.
Related: Preparing for VBAC
Talk to your health care provider about whether or not you can do it safely.
Can I have an elective c-section?
Well momma, it depends on your medical provider. Most medical professionals will discourage you unless there’s a medical reason for it. Unfortunately, many women who ask for a c-section are doing so because they are fearful of childbirth.
While that’s a totally normal thing to feel, keep in mind that overall a c-section is major surgery, and should be treated as such. There’s going to be some pain associated with the birth of your little one – and there’s no way around that.
The American College of Obstetricians and Gynecologists do not recommend getting an elective c-section. If you still want to discuss the option with your medical provider, be aware that there are typically a few hoops you have to jump through before your provider will consider agreeing to this.
Recovery of c-section vs vaginal birth
Wondering what the difference is between recovery of a vaginal birth vs c-section? It’s somewhat individual depending on the momma.
Overall, a c-section usually requires more time to heal. Not only did you go through MAJOR surgery, which carries more risk than a vaginal birth, but your hospital stay will be longer, and it’s going to take more time before you can move around normally.
The big difference worth noting is that c-section recovery is typically more difficult.
C-section vs vaginal birth weight loss
Typically, it’s recommended that you go longer before exercising after a c-section versus vaginal birth. Because of this – it’s possible that you may experience more difficulty losing weight after a c-section (although really it usually just takes a little longer).
This is another one of those things that is highly variable, and it’s going to be different for all momma’s. There are a few things you can do regardless of how you gave birth that’ll help with weight loss. Breastfeeding, eating healthy, and patience are key to getting back to your pre-baby weight.
I also recommend checking out this postpartum program. My friend Katie is a postpartum specialist who teaches women how to lose the baby weight, strengthen that pelvic floor, and be healthier after pregnancy.
Can I avoid getting a c-section?
Sometimes no. There are some things you can do to help minimize the risk of needing a c-section, but unfortunately, there are circumstances where it’s still going to be medically necessary.
Here are some things you CAN avoid that would otherwise increase your risk of getting a c-section.
- Hire a doula. There have been multiple studies that show us that using a doula can reduce your risk of needing a c-section, as well as shorten the time spent in labor and the amount of pain medication used. This just goes to show how important support is – so if you can’t get a doula I recommend having someone present that can be a good support system for you.
- Avoid an elective induction. More and more women are choosing to get induced, especially now that the ARRIVE study has come out saying that elective inductions may actually DECREASE your odds of a c-seciton. While this study is OUT- I, personally, as a labor and delivery nurse am VERY skeptical of the results, and I’ve seen countless patients who get electively induced, who wind up with c-sections. I believe there is a link, but obviously, I’m not a researcher-just a nurse who has labored hundreds of patients!
- Put off that epidural. While there’s totally nothing wrong with going the epidural route, getting it too early can increase your risk of needing a c-section, especially if it’s your first baby, or if you had a previous c-section.
- Check with your provider. You can definitely ask your medical provider what their cesarean rate is for first-time mothers.
Look momma – you get to choose what you think is best for you and your family. While traditional vaginal birth is typically safer, that’s not the best option for everyone.
Have a serious talk with your medical provider and work out what is going to be best for you and your new baby. Good luck!
I’ll mention it one more time – if you’re looking for some clear instruction on what to expect during labor and delivery, check out my birthing course Birth It Up! Use the code INSTA to save 10%!