It’s long been a hot topic of debate – natural childbirth versus caesarean birth. Around 30% of babies in Australia each year are born via caesarean section, with about 70% born vaginally – some of those will be natural and a much smaller proportion will be with forceps or Ventouse.
So which option should you choose?
In general, natural childbirth is considered the safer option. I believe that natural birth is what we should be aiming for - but that this important decision is one that each woman should make for herself. However, there may be factors to take into consideration when making your decision, factors that may make a caesarean birth safer for mother or baby.
With natural childbirth, you can limit the amount and type of pain relief that you use, with some women opting to keep both themselves and their baby totally drug free for the duration of the birth. On the other hand, we know that labour and childbirth can be long and painful and there are very safe methods to reduce or minimise pain. Many women find a great sense of achievement from succeeding at this most human of tasks, irrespective of the methods of pain relief, if any, used in the labour.
For a small proportion of women, less attractive aspects of vaginal birth include the sometimes long and intense labour process, the possibility of pelvic floor or perineal damage and the chance of a prolonged recovery.
Now let’s look at caesarean birth.
While many thousands of these operations are carried out every year, it’s important to remember that a caesarean is major abdominal surgery. And, like any surgery, it comes with its own set of risks, from reactions to anaesthetic drugs to blood loss or unforeseen complications.
A caesarean delivery can occasionally take a little longer to recover from, compared with a vaginal birth. Typically, mothers are able to get up the day after a caesarean birth and are usually able to manage with Panadol and anti-inflammatory drugs for pain relief, after two or three days. They are able to drive after two or three weeks and getting back to more intense exercise by six weeks.
There are certain circumstances where a caesarean birth can be considered the safer birth option, such as with ‘breech’ babies (where the baby is coming bottom or legs first), in cases of placenta praevia (where the placenta is sitting over or close to the cervix) or when twins or triplets are to be born.
If you have previously had a baby by caesarean, it is marginally safer to have your next child by the same method. That doesn’t mean you can’t have your baby naturally if you have previously had a caesarean, but it does mean that the medical team will keep a closer eye on things during labour to ensure that there are no difficulties, or that we can intervene early if there are signs of problems in the labour.
One misconception about caesarean births is that they help to prevent prolapse or incontinence later in life. More recent evidence suggests that becoming pregnant will predispose to prolapse and incontinence in your older years, not the method of birth of the baby.
Caesarean births can be a much less threatening process for women who have an intense fear of labour or the pain of childbirth, or who have had a particularly traumatic experience with a previous vaginal birth. They also have the minor advantage of predictable scheduling – you know when your baby will be born and can plan around that timing.
As I said in the beginning, I believe that in most circumstances, natural childbirth is the preferable option. In the end, the decision, often made in consultation with your specialist, must always be yours. You should not feel pressured by other people. Do your research, talk to your doctor and midwife, and make up your own mind.