C-Section vs. Natural Birth: Which is the Better Option?

Last Updated: February 13, 2024
Liesel Teen, RN-BSN

By Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

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The topic of C-section vs. natural birth is more and more frequent as c-sections are increasing dramatically in the US. In this case, natural birth is referring to vaginal birth.

But the quick answer to which is better? 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.

But I get it. Mamas wonder…Should I risk tearing and possible complications with a vaginal birth? On the other hand, is it worth the healing time of a C-section 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.

Which is why I want to talk to you about the pros and cons of C-section vs natural birth so you’ll be empowered to make the decision that best fits your needs.

Read on, mama!

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Common myths regarding C-sections

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 planned 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 some scenarios where C-section IS the safer option.

Pros and cons of C-sections vs natural birth

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 natural birth, so I wanted to share some of the actual benefits of choosing a C-section.

C-section benefits:

  • 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 mama’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 with a good prenatal fitness program!

See? It’s understandable why some women think that you’re better off getting a C-section. Those are some pretty good pros. 

C-section cons

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)
  • Can make breastfeeding more difficult in the beginning (although still TOTALLY doable)
  • Increases the chance of stillbirth or miscarriage in a subsequent pregnancy

These are some pretty serious drawbacks, and while most women will not experience these problems, some do.

Related Reading: 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. We are designed to give birth this way after all!

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, is pretty darn safe.

Related Reading: 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 (vaginal birth cons)

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
  • Tearing
  • More painful labor
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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.

1. 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.

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.

2. If you’ve had a C-section with a previous birth – especially if 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 natural 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.

Interested in a VBAC? Read more about VBACs here.

3. 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.

4. 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.

5. 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!).

6. 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. 

Why do emergency C-section’s happen?

Emergency C-sections are a reality for some mamas, 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. And why childbirth education in general is so important. A good birth course will prepare you for any and all outcomes. Learn more about mine here!

Here are some of the common reasons you may need an emergency C-section

  • Breech, transverse, or other mal-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, shoulder, or side-first, they can get STUCK. Some babies just don’t know the rules yet
  • Cord prolapse: 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. 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
  • Fetal distress: 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
  • Placental abruption: when the placenta separates from the uterus early)
  • 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
  • An extremely long labor: sometimes this can lead to some of the complications above, and sometimes mama can become dangerously exhausted or dehydrated from laboring for too long
  • Mama spikes a fever: this can indicate a problem or infection and can result in trying to get baby out as quickly as possible

Related Reading: What Happens in C-Section Recovery

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.

Related Reading: Epidural Facts (you probably didn’t know)

If I have a C-section, does that mean that any following births must also be by C-section?

Luckily, no. VBACs (vaginal birth after C-section) are 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.

Talk to your health care provider about whether or not you can do it safely.

Can I have an elective C-section?

Well mama, 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 natural birth

Wondering what the difference is between recovery of a C-section vs a natural birth? It’s somewhat individual depending on the mama.

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. 

Read more about recovery after C-sections and recovery after natural birth!

C-section vs natural birth weight loss

Typically, it’s recommended that you go longer before exercising after a C-section vs natural 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 mamas. 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.

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.

  1. 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. Learn more about doulas in this episode of my podcast
  2. Avoid induction (especially 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-section. 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!
  3. 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. In my epidural course, we talk about the optimal timing for your epidural and what to expect
  4. Check with your provider. You can definitely ask your medical provider what their cesarean rate is for first-time mothers

C-section vs natural birth: you and your provider will decide

Look mama – 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!

Keep learning! Read more about C-sections:

Birth Plan
Liesel Teen, RN-BSN

Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

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