Natural childbirth or Caesarean?

Proven content

For years, women have given birth naturally. Also today, the overwhelming majority of pregnant women give birth through the ways and forces of nature. However, some mothers-to-be, fearing the pain and complications, want to have a caesarean section. Learn about the advantages and disadvantages of cesarean section and natural delivery.

All about caesarean section

There is nothing more wrong and illusory than the belief that cesarean delivery is safer than vaginal delivery. Even in the age of medical advances, including anesthesiology, there are deaths of women giving birth by caesarean. Mortality in this group is 1 in 5 births. Deaths are mainly caused by postoperative complications. Remember that a cesarean section is not a “procedure”. The latter term is often associated with something frivolous, while Caesarean section is an operation to open the abdominal cavity. Of course, there are clear indications for a cesarean section. However, these are well-defined situations in which the threats to the life and health of the pregnant woman and her child outweigh the risks associated with the operation. Caesarean section is therefore a procedure of choice in a situation where the life of the mother is at risk (e.g. eclampsia, hemorrhage, risk of uterine rupture) or the fetus (placenta detachment, threatening intrauterine asphyxia).

In addition to the emergencies mentioned, there are also selective indications for elective Caesarean section. Most often it is done for non-obstetric reasons, with the coexistence of maternal diseases that prevent the proper course of natural labor. Such conditions include: heart defects, severe vision defects, bronchial asthma and other lung diseases. Elective cesarean section is also performed for orthopedic indications related to bone defects in the small pelvis, and for neurological or psychiatric indications.

There are also selective indications on the part of the fetus:

1. pelvic position,
2. multiple pregnancy,
3. incorrect insertion of the head into the birth canal,
4. birth disproportionate.

A patient who requires a cesarean section must sign an informed consent form for this procedure and a separate consent to anesthesia.

It is worth remembering that – if the indications for caesarean section do not repeat – another pregnancy may end in vaginal delivery – unless the woman giving birth does not consent to it. However, the problem arises if there are absolute indications for cesarean section in the next pregnancy. The massive adhesions left over from the previous operation sometimes make it very difficult to open the uterus and extract the fetus. Meanwhile, the prolonged duration of the procedure adversely affects the fetus.

Recently, there are also reports that children born by caesarean section show some deviations in their further development compared to their peers born by natural forces. For example, it has been shown that in the former group the frequency of bronchial asthma appearing in childhood is higher.

You should consider all the pros and cons when you talk to your doctor about your route of delivery. If a cesarean section is to be performed only because you are afraid of pain, the risks of having a cesarean section far outweigh the potential benefits. It should also be remembered that the recovery period after an operation, such as a cesarean section, is much longer than in the case of an episiotomy in natural childbirth.

What does natural childbirth look like?

Natural childbirth consists of several stages. Each of the different stages of labor has different characteristics. A pregnant woman waits nine months for the time of delivery to finally see her baby. However, at the same time, he feels anxiety and fear that everything will go according to plan.

1. The first phase of labor – opening the cervix. The woman has the first uterine contractions which are rare and painless at first. Some women may not feel them at all, especially if they appear while sleeping at night. Over time, uterine contractions begin to get stronger and become more frequent and intense. At the end, they appear approximately every two minutes and last for approximately 60 seconds. The contraction of the uterus usually begins at the apex and widens downwards, resulting in the appearance of gaps. Then, the membranes are ruptured and the amniotic fluid flows out.

How long do uterine contractions take?

They usually last until the cervix is ​​fully dilated, 10 cm (for 5 fingers). This is the moment when the child is getting ready to go out into the world.

The first stage of labor is the longest. It can last from 6 to even 20 hours. It is a very individual matter, depending on the number of deliveries and the predisposition of the pregnant woman. How to survive this time? One way is to keep the pregnant woman moving for as long as possible, as long as she is able to walk. By movement we mean stretching exercises on a medicine ball, walking or breathing exercises. The first phase of labor is also characterized by a woman’s changing moods – from excitement to fear and fear of the unknown.

2. The second phase of labor – pushing. This is the moment when the cervix is ​​fully dilated and the water has broken. This stage in women giving birth for the first time usually lasts about two hours. On the other hand, in women who have already given birth, this time may be shortened even to 30 minutes. At this stage, the baby passes through the birth canal thanks to the contractions of the uterus and the strong pushing movements of the diaphragm, i.e. pushing. The pressure is greater when the woman makes a slight forward bend and tightens the abdominal muscles (it is worth asking your partner or someone close to you for help). It is very important not to forget about proper breathing when pushing the baby through the birth canal. It is very important for the proper oxygenation of the child and the breaking of blood vessels on the face or in the eyeballs.

Some women require an episiotomy. The second phase of labor ends with the baby being born.

3. The third phase of labor, the so-called bearing. After the baby is born, the woman must then give birth to the placenta and membranes, which will be felt as a need for a little pressure. The placenta is painless, and careful removal is essential, so it is always checked that it is complete and complete. If the placenta is not completely expelled, curettage of the uterine cavity is necessary.

4. The fourth phase of labor. It is the care of the mother and the child in the hospital ward. A newborn baby is subjected to a detailed assessment – weighed and measured and assessed on the APGAR scale. A child with no abnormalities is given 8-10 points in the APGAR scale. The baby is then handed over to the mother and can be fed for the first time.

Natural childbirth or Caesarean?

Physiologically, pregnancy ends in natural delivery. In recent years, however, cesarean delivery has become more and more popular. It is very often performed on women “on request”. Of course, there are times when there is no other way out, and a cesarean section is a must for the health of the mother and baby.

Advantages of natural childbirth

– consciously participating in the most important event in life;

– the child is immediately given to the mother after delivery, thanks to which she establishes a bond with him;

– women recover faster after natural childbirth;

– after natural childbirth, a woman does not need to take care of the scar on her stomach (in the case of an episiotomy, proper care will make the scar imperceptible);

– a child is born when he is ready for it.

Disadvantages of natural childbirth

– natural childbirth lasts from a few to several hours and requires a lot of physical effort and is associated with great pain;

– childbirth can take place at any time, at the least expected moment;

– sometimes the vaginal and perineal tissues are damaged, which later may lead to, for example, urinary incontinence.

Advantages of a cesarean section

– a cesarean section is an elective procedure. Some women know the exact date of their baby’s birth;

– the woman during the cesarean section will not be tired of prolonged contractions and pressure;

– the vagina and the perineum remain intact (which is important for many women in terms of sexual attractiveness);

– there is a lower risk of your baby becoming infected with your vaginal flora;

– the baby will not be as tired as during natural childbirth, and will also have a “normal” deep shape.

Natural childbirth after cesarean

The gynecologist who conducts your next pregnancy must be informed about the reasons for the cesarean section in your previous pregnancy. If there are still factors for caesarean birth, you should not opt ​​for natural birth as the risk is too great. Natural childbirth after cesarean is possible only when the woman is healthy, the pregnancy is developing properly and without any disturbances, and the baby is in the cephalic position. The absence of these conditions makes natural childbirth impossible in a woman after cesarean section, as it is associated with a lethal risk for the mother and child.

The greatest danger of natural childbirth after cesarean delivery is the risk of uterine rupture during childbirth. This is due to the presence of a cesarean scar, through which the tissue may come apart during labor due to high pressure and pressure. The result of uterine rupture is severe haemorrhage and even loss of this organ.

Natural delivery after caesarean section is considered a high-risk delivery. The recommendations of the Polish Gynecological Society say that the condition of women giving birth and their babies should be constantly monitored with CTG. Natural childbirth after cesarean section requires a lot of patience and increased maternal care. In such a delivery, oxytocin is not administered because it supports contractile activity, which in turn increases the risk of uterine rupture. In addition, the medical staff and the operating room must be prepared to perform a caesarean section at any time.

Text: lek. med. Ewa Zarudzka

Natural childbirth or caesarean section?

The number of women who decide to have a caesarean section is increasing