C-Section vs. 'Natural Birth': What's the Difference?
Ask a group of moms about their birth stories, and chances are at least one of them delivered by Cesarean section. In fact, about one-third of all babies are born through C-section today. Some surgeries are planned (elective) while others are done after labor already began (emergency).
Planned or Elective C-sections: Doctors may schedule a C-section if it's considered safer than vaginal delivery for medical reasons—for example, pregnancy with multiples, a large baby, breech presentation (the baby is feet-first instead of head-first), previous C-section, or maternal medical issues like high blood pressure, heart disease, or diabetes.
Emergency C-sections: Something may happen during labor to necessitate a C-section. In most cases, an unplanned C-section happens if the labor doesn't progress normally, the fetus is in distress, or there's other worrisome problems like placental abruption or a prolapsed umbilical cord. An emergency C-section can be life-saving for a mother and her baby.
Many women try comparing C-section and vaginal delivery (which is sometimes called "natural birth," although this term is outdated and slightly misleading, because all methods of birth are natural processes). But at the end of the day, there's no better way to experience childbirth. As Sherri Bayles, a New York City-based certified Lamaze instructor, lactation consultant, and registered nurse, says: "The important thing is to have a healthy baby—it doesn't matter how he gets here." Here are the differences between C-sections and vaginal deliveries, so moms-to-be can be prepared for either scenario.
The Procedure: C-Section vs. "Natural Birth"
During a vaginal birth, the mother will experience labor as her cervix dilates. Uterine contractions, which feel like super-strong menstrual cramps, move the baby's head toward the vaginal opening, where it emerges after pushing. Some women opt for painkillers like an epidural, while others go medication-free. You'll probably be able to hold your little one immediately after the birth. Labor and delivery can last 12 to 14 hours for first-time moms, and it's usually quicker for subsequent births.
A C-section operation, on the other hand, usually takes about 45 minutes from start to finish (the baby is born in the first 10 to 15 minutes). The vast majority of C-sections are performed while the mother is awake, and she usually receives either an epidural or a spinal block to numb the lower half of the body. The surgery itself won't hurt due to the pain killers—although you may feel pressure during your C-section and a tugging sensation when the baby is pulled out.
Inside the operating room, the doctor makes an incision just above your bikini line and into the wall of the abdomen. Another incision is made in the wall of the uterus through which the baby is delivered. Then doctors cut the umbilical cord, remove the placenta, and close the incision. They'll put up a screen so you won't see the surgery being performed, but barring any complications, you'll be able to hear your baby as soon as they're born and hold them soon afterward.
Recovery and Healing: C-Section vs. "Natural Birth"
Recovery time is difficult to predict, because different moms experience different levels of post-operative soreness. Most women stay in the hospital for 24-48 hours after a vaginal birth. Postpartum side effects include vaginal bleeding, cramping, swelling, soreness, and more. New moms should take it easy for at least a few weeks after vaginal delivery.
If you have a C-section, side effects tend to be more severe. You may feel a little nauseated and weak during the first day; coughing, sneezing, and laughing may cause pain. After a day or so, you'll be encouraged to get up and start moving around, which is important to prevent fluid from building up in your lungs, boost circulation, and help with digestion. You'll probably be able to go home in 3-4 days, after your doctor removes your stitches (sutures will dissolve on their own) and places Steri-Strips over the wound. You'll get a prescription for pain medication, and you should spend the next few weeks focusing on resting and wound care. Although the pain will linger for a while, you'll probably be back to your old self in about a month to six weeks.
Complications: C-Section vs. "Natural Birth"
In a "natural birth," the woman may suffer perineal tears, or she might need an episiotomy—a cut made to enlarge the vaginal opening. These complications often require stitches, and they can cause significant pain. Issues with bladder control are also possible after birth, and so is pelvic organ prolapse. (An upside of vaginal birth, though, is that babies exposed to bacteria in the birth canal have boosted immune systems. What's more, mothers might be able to hold and breastfeed their baby sooner with vaginal births, which improves the early bonding experience.)
In terms of C-section risks, potential maternal complications include infections of the uterine lining and incision; excessive bleeding or hemorrhage; injury to the bladder or bowel during surgery; negative reactions to anesthesia; and blood clots like deep vein thrombosis (DVT) and pulmonary embolism. Women who had prior C-sections also risk uterine rupture (their C-section incision rips open), which can cause life-threatening bleeding. Placenta previa (the placenta partially or entirely covers the cervix) and placenta accreta (the placenta implants into the uterine muscle instead of the lining) are also more common in subsequent C-sections, says David Colombo, M.D., Director of Maternal Fetal Medicine at Spectrum Health. Keep in mind, however, that C-section complications are rare, and the surgery is considered generally safe.
While C-section risks to the baby are minimal, they sometimes develop respiratory issues, especially if they're born before 39 weeks. Labor helps release fluid from the baby's lungs; since many C-section mothers don't go through labor, their babies don't reap the same benefits. Rarely, C-section babies could be injured during surgery, and they sometimes have temporarily low Apgar scores.