Is natural childbirth or cesarean section better? – Advantages and disadvantages

By (embryologist), (gynecologist), (gynecologist), (embryologist) and (psychologist).
Last Update: 11/24/2021

The decision on how to deliver a baby, natural childbirth, or cesarean section, is not up to the parents-to-be.

Normally, the specialist doctor who follows the pregnancy and who will deliver the baby will be responsible for determining which method is best for the characteristics of the woman, the baby, and each particular situation.

In addition, once the time of delivery has come, it may be necessary to change your mind in order to avoid risks. This is often the case when a vaginal delivery was initially scheduled and a cesarean section was subsequently performed.

Natural childbirth

Natural or vaginal childbirth refers to the delivery of the baby through the mother's vaginal opening. For this to happen, this orifice must dilate, giving rise to the characteristic labor pain. Uterine contractions that help expel the fetus are also responsible for this pain.

It should be noted that although the terms vaginal birth and natural child birth refer to the same thing, they are not. This means that vaginal delivery is not always natural, since it is possible to use epidural anesthesia.

It is understood as natural when a vaginal delivery takes place without the intervention of any drug to relieve the pain caused by the dilatation of the vagina.

The following are the benefits and drawbacks of vaginal delivery, regardless of whether or not anesthesia is used.

Advantages

For most women, natural childbirth is a unique experience, as they can be aware of the entire process and see the baby as soon as it is born. In addition to this, there are other positive factors in favor of natural childbirth:

  • It does not require surgical intervention, which carries risks of hemorrhage, clots, intestinal blockages, etc.
  • The recovery period is much faster and less painful than a cesarean section. The woman can almost immediately return to her normal life.
  • Blood loss during labor is less than in the case of cesarean section.
  • There is a lower risk of developing urinary or endometrial infections (endometritis).
  • The baby has better general and cerebral oxygenation. Their adaptation to extrauterine life is less traumatic as they go through labor.
  • There is stimulation of the baby's senses during its passage through the birth canal.
  • It is possible to have more children without waiting many years between one and another and, in addition, there is no limit to the number of vaginal births a woman can have.
  • The mother's body releases oxytocin to promote milk formation and bonding between mother and baby.

It is also important to point out that, contrary to what happens in cesarean delivery, the father-to-be can be part of the moment of the birth of his child during natural birth, being a great support for the mother.

Disadvantages

However, natural childbirth also has a number of disadvantages that the woman should be aware of, although they are less than in the case of cesarean section. Listed below are some of the disadvantages of vaginal delivery:

  • The pain is very intense at the time of delivery due to the dilation of the vagina and contractions.
  • There is a risk of tearing of the perineum.
  • An episiotomy (vaginal cut) may be necessary to facilitate the baby's exit.
  • Risk of postpartum urinary incontinence or sexual dysfunction.
  • The duration of labor. New mothers dilate an average of one centimeter per hour, and this phase of labor can last up to 10 hours or more.

Nevertheless, it is not possible to know exactly when the woman will begin to feel contractions to go to the hospital. Therefore, the woman must be alert for several days until she is discharged.

Cesarean delivery

Cesarean delivery is one in which the baby leaves the mother's womb through a cut made in the woman's abdomen and uterus. This is a major surgical procedure and, as such, presents certain risks.

The cesarean section must be performed under anesthesia. Epidural anesthesia is now commonly used, although in the past it was common to use general anesthesia.

It is quite common in society to hear that a baby born by cesarean section suffers less during delivery and, therefore, is born with better color and appearance. However, a cesarean section can also be complicated and present several health risks for both mother and baby.

Advantages

Some benefits of cesarean delivery are as follows:

  • There is no pain during delivery due to anesthesia.
  • The procedure time is short, about 30 minutes if everything goes well.
  • The exact day the baby will be born is known if the cesarean section has been scheduled.
  • There is a lower risk of complications for the baby.
  • There is no trauma to the vaginal area and, therefore, the risk of urinary incontinence is lower.

In addition to these benefits, the cesarean section also makes it possible to avoid emergency surgery if natural childbirth does not go well. This would reduce morbidity.

Disadvantages

Although it is often necessary to perform a cesarean section to save the baby's life, the truth is that this procedure has more disadvantages than vaginal delivery:

  • Risks of infection and damage to other organs as in any surgical intervention.
  • Postpartum recovery is painful and much slower, between 4 and 8 weeks.
  • The baby's senses are not stimulated during delivery.
  • The hormone oxytocin is not generated and adaptation to breastfeeding may be more costly.
  • The woman walks with difficulty the first few days after leaving the hospital.
  • It is not recommended to have more than three cesarean deliveries.
  • It is necessary to wait at least one year to become pregnant again after cesarean section.
  • There is a risk of uterine rupture if the woman has a vaginal delivery after giving birth by cesarean section.

In addition to all this, contrary to what happens with natural childbirth, it is not possible for the father or any other accompanying person to be present during the intervention.

FAQs from users

Do breech deliveries always end in cesarean section?

By Rubén Baltá I Arandes M.D. (gynecologist).

Breech presentation (breech or feet down) has an incidence of between 3 and 4%. Vaginal delivery in breech presentation has shown a higher incidence of problems at delivery and poor perinatal outcomes compared to cephalic delivery.

Therefore, it is a medical indication to perform a scheduled cesarean section at 39 weeks, which is considered a safer procedure for the newborn. However, cesarean section is not free of maternal risks mainly, so one of the current recommendations is to perform an external cephalic version (attempt to turn the baby by external obstetric maneuvers).

By Rafael Collazos Robles M.D. (gynecologist).

Childbirth is the most special and awaited moment for most pregnant women. Delivery can be done vaginally or by cesarean section.

The most physiological route is the vaginal route. However, there are circumstances in which delivery by cesarean section is indicated to safeguard the health of the mother and fetus.

There are 3 types of cesarean section:

Elective cesarean section
is performed in the presence of some maternal or fetal pathology such as placenta previa, breech, transverse or oblique presentation, fetal macrosomia, active infections of the birth canal, 2 previous cesarean sections, some cases of growth disturbance and multiple gestations.

The indicated cesarean section
is recommended in the course of labor for various alterations such as arrested dilatation or descent, cephalopelvic disproportion, arrested labor, etc.
Cesarean section
is recommended in the course of labor for various alterations such as arrested dilatation or descent, cephalo-pelvic disproportion, arrested labor, etc.
Urgent cesarean section
is one in which the life of the mother and fetus is in danger as a result of a serious acute pathology.

Which is better, vaginal delivery or a cesarean section?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

There are many theories about how childbirth should be, as well as many doctors in favor of cesarean section and many advocates of natural childbirth.

It should be noted that vaginal childbirth is a natural process. The woman's body is hormonally and mechanically prepared to be able to carry it out even without medical intervention. However, unforeseen events may arise at the time of delivery that force professionals to decide to perform a cesarean section.

On the other hand, there are women who prefer to give birth by cesarean section because they are afraid of pain, but it should be noted that the recovery is much worse than with natural childbirth. In addition, women with cesarean section will need assistance and help from family members during the first few days, both for daily routines and to take care of the newborn.

In any case, at the moment of delivery, the health of both the future baby and the mother who is going to give birth will always be taken into account.

What are the indications for a cesarean section?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

The general course of action at the end of a pregnancy is natural childbirth and a cesarean section will only be performed in certain situations such as the following:

  • Abnormal heart rate of the baby
  • Position of the baby that hinders natural childbirth
  • Developmental problems of the baby such as spina bifida or hydrocephalus
  • Some cases of multiple pregnancies
  • Genital infection of the mother
  • Serious illness of the mother
  • That the natural delivery is prolonged too long
  • Placenta praevia or placental abruption
  • Prolapse of the umbilical cord

In general, any situation that endangers the life of the baby or the mother will be indicative of a cesarean section.

Is cesarean delivery good or bad?

By Marta Barranquero GĂłmez B.Sc., M.Sc. (embryologist).

As with vaginal birth, there are advantages and disadvantages when a baby is delivered by cesarean section.

For example, one benefit of cesarean section is that the woman will not feel pain and the procedure is short, about 30 minutes. In addition, scheduled cesarean delivery allows the woman to know the exact day she will have her baby in her arms.

However, cesarean section is a surgical procedure and infections and/or damage to other organs may occur. In addition, in the case of wanting to breastfeed, it will be more complicated because oxytocin is not generated.

If you want to know all the details about the cesarean section, we recommend you to visit the following post: How is a cesarean section performed?

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References

Cristina Mascarello K, Lessa Horta B, Freitas Silveira M. Maternal complications and cesarean section without indication: systematic review and meta-analysis. Rev Saude Publica. 2017;51:105. doi: 10.11606/S1518-8787.2017051000389. Epub 2017 Nov 17.

Ivanov S, Tzvetkov K, Kovachev E, Staneva D, Nikolov D. Puerperal infections after Cesarean section and after a natural childbirth. Akush Ginekol (Sofiia). 2014;53 Suppl 1:25-8.

Sharma S, Dhakal I. Cesarean vs Vaginal Delivery : An Institutional Experience. JNMA J Nepal Med Assoc. Jan-Feb 2018;56(209):535-539.

Velho MB, Atherino dos Santos EK, Sorgatto Collaço V. Natural childbirth and cesarean section: social representations of women who experienced them. Rev Bras Enferm. Mar-Apr 2014;67(2):282-9. doi: 10.5935/0034-7167.20140038.

FAQs from users: 'Do breech deliveries always end in cesarean section?', 'When is natural childbirth recommended and when is cesarean delivery recommended?', 'Which is better, vaginal delivery or a cesarean section?', 'What are the indications for a cesarean section?' and 'Is cesarean delivery good or bad?'.

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Authors and contributors

 Marta Barranquero GĂłmez
Marta Barranquero GĂłmez
B.Sc., M.Sc.
Embryologist
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Rafael Collazos Robles
Rafael Collazos Robles
M.D.
Gynecologist
Degree in Medicine and Surgery from the Universidad de San MartĂ­n de Porres (Lima, Peru). Doctor in Medicine and Surgery from the University of Salamanca. Master in Human Reproduction by IVI and Universidad Rey Juan Carlos de Madrid. Assistant Physician of the Obstetrics and Gynecology Service of the Hospital San Rafael and gynecologist specializing in Reproductive Medicine at Fertility Madrid. Vice-president of the SEGECI. More information about Rafael Collazos Robles
Member number: 282863485
 Rubén  Baltá I Arandes
Rubén Baltá I Arandes
M.D.
Gynecologist
Dr. Rubén Baltá has a degree in Medicine and Surgery from the Autonomous University of Barcelona and a postgraduate specialization in Esthetic and Functional Gynecology and Women's Cosmetic Genital Surgery from the University of Barcelona. More information about Rubén Baltá I Arandes
Medical licence: 070709574
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Cristina  Algarra Goosman
Cristina Algarra Goosman
B.Sc., M.Sc.
Psychologist
Graduated in Psychology by the University of Valencia (UV) and specialized in Clinical Psychology by the European University Center and specific training in Infertility: Legal, Medical and Psychosocial Aspects by University of Valencia (UV) and ADEIT.
More information about Cristina Algarra Goosman
Member number: CV16874

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