C-Section vs. 'Natural Birth': What's the Difference?

Ask a group of parents about their birth stories, and chances are at least one (or more) of them delivered by Cesarean (C-section) section, a procedure used to deliver a baby surgically. In fact, about one-third of all babies are born via C-section. The rest are born vaginally, which is also sometimes called "natural birth."

Most pregnant people plan to deliver their baby vaginally, while others schedule a C-section for a variety of reasons. Most C-sections are planned (elective), but others are performed on an emergent basis after labor has already begun (this is called an emergency C-section). Learn more about the differences between vaginal births and C-sections.

Types of C-Sections

Typically, most babies are born vaginally. However, if complications occur, either generally in the pregnancy or during labor, a C-section may be planned or done on an emergency basis.

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.

Additionally, sometimes, pregnant people choose to have an elective C-section, for personal reasons, such as due to scheduling issues or fear of childbirth. Note that it's typically recommended to try for a vaginal delivery unless there are medical reasons that make a C-section safer. However, what's right for you also matters. This is a personal decision that the pregnant person gets to make with their medical provider.

Emergency C-sections

Emergency C-sections are done when something happens during labor to necessitate delivering the baby right away. In most cases, an unplanned C-section happens if the labor doesn't progress normally, the fetus or expecting parent is in distress, or there are other worrisome problems like placental abruption or a prolapsed umbilical cord. An emergency C-section can be life-saving for the pregnant person and their baby.

The procedure itself is essentially the same as a planned C-section, except that it typically is done much more quickly.

Many pregnant people try comparing C-sections with vaginal delivery (which is sometimes called "natural birth," although this term is outdated and misleading, because all methods of birth are natural processes). But at the end of the day, there's no better or worse 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 main differences between C-sections and vaginal deliveries, so parents-to-be can be prepared for either scenario.

The Procedure: C-Section vs. "Natural Birth"

Sometimes, a pregnant person will go through labor and then end up with a C-section. Other times, with a C-section, the surgery will happen before labor begins, so they won't experience any contractions at all.

Vaginal delivery

During a vaginal birth, the expecting parent will experience labor as their cervix dilates. Uterine contractions, which feel like super-strong menstrual cramps, digestive distress, and/or intense backache, move the baby's head toward the vaginal opening, where it emerges after pushing.

Many pregnant people opt for painkillers like an epidural, as the experience is typically quite painful and lasts several hours. Others choose to go through this process medication-free. There is no right or wrong way to approach pain medication during childbirth, just what works best for you.

You'll probably be able to hold your little one immediately after birth. Labor and delivery can last 12 to 14 hours (or longer) for first-time parents. It's usually quicker for subsequent births, but not always. Just like every pregnancy is different, each birth experience is also unique—and often doesn't go exactly as planned or expected even if you've done it before.

C-section delivery

A planned C-section operation usually takes about 45 minutes from start to finish (the baby is born in the first 10 to 15 minutes). In an emergency C-section, the baby may be delivered in just minutes.

The vast majority of C-sections are performed while the pregnant person is awake, and they usually receive 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 medication—although you may feel pressure during your C-section and a tugging sensation when the baby is pulled out.

In an 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 typically put up a screen so you won't see the surgery being performed, but barring any complications, you'll be able to hear and see your baby as soon as they're born and hold them soon afterward.

Recovery: C-Section vs. "Natural Birth"

Recovery time is difficult to predict because different people experience different levels of post-operative soreness. The pregnant person's medical history and postpartum support as well as the length of labor and any complications that occur during childbirth will impact how long healing takes.

After a vaginal birth, most new parents stay in the hospital for 24-48 hours. Postpartum side effects include vaginal bleeding, cramping, swelling, soreness, constipation, and more. New parents should take it easy for at least a few weeks after vaginal delivery.

If you have a C-section, the above side effects tend to be more severe. You may feel a little nauseated and weak during the first few days; coughing, sneezing, and laughing may cause pain. In the first day or two, you'll typically be encouraged to get up and start moving around, even for short periods. Walking 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 2-4 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, wound care, and taking care of your baby. 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 pregnant person may experience perineal tears, or they might need an episiotomy—a cut made to enlarge the vaginal opening. These complications often require stitches and 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. Plus, you might be able to hold and breastfeed your baby sooner with vaginal births.

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. People who had prior C-sections also risk uterine rupture (their C-section incision rips open), which can cause life-threatening bleeding.

Placenta previa (when the placenta partially or entirely covers the cervix) and placenta accreta (when 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 in Grand Rapids, Michigan.

Keep in mind, however, that C-section complications are rare, and the surgery is considered generally very safe.

While C-section risks to the baby are minimal, they sometimes develop respiratory issues, especially if they're born before 39 weeks. Labor and vaginal delivery help release fluid from the baby's lungs; since many C-section parents 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.

The Bottom Line

It's typically recommended to have a vaginal birth, if possible. However, the need to have a C-section usually depends on medical factors out of your control. And C-section is also a safe way to have a baby. It's normal to feel a bit of disappointment or worry about having a C-section, but remember that this is a lifesaving surgery. Moreover, both types of birth should be celebrated because they each result in the greatest gift—a baby!