What Doctors Don’t Tell You About C-Section vs. Natural Birth

Creating a birthing plan is one of the most important things expectant parents will do as they prepare for the arrival of their son or daughter.  Part of that plan is discussing options such as the delivery hospital, whether to use a doctor or midwife and whether to have a Cesarean section (c-section) or a natural birth.

For many years, the debate between c-section versus natural birth has caused tension between women.  Many women believe that a c-section should only be an option as a last resort, and should never be “elective”.  Other women prefer the option of a c-section, or have medical factors making it a more desirable, often necessary, choice.

Many women feel like they don’t have enough information to decide which option is preferable.  That is because there are many things that doctors don’t tell women about c-section versus natural birth.  At Birth Injury Guide, we want women to be as informed as possible so that they can make healthcare decisions with confidence. Read on to learn more about c-sections and natural birth, and what you might not be aware of.

What Doctors Don’t Tell Women about C-Section Vs. Natural Birth

No matter which side of the debate you are on, the fact of the matter is that the choice should be between you and your healthcare team based on the best interests of you and your baby.  Even though you may not like the idea of a c-section, you should be open-minded to the possibility that it could be necessary. Learn as much as possible about both options before you give birth in order to feel more confident no matter which option is best.

Here are some things about the debate that your doctor may not tell you, or may not clarify for you.

One is Not Easier Than the Other

Some women argue that one birth method is easier than the other.  While a c-section may not require pushing and the same degree of labor, it is not without its own difficulties.  Natural birth may be more difficult during the process, but a c-section is a major surgery that requires lengthy recovery and healing time.  A c-section also has inherent risks as a surgical procedure. Many women also struggle emotionally with how their birth situation plays out. A traumatic birth of either type can be hard to deal with.

C-Sections Save Lives

C-sections get a bad reputation thanks to celebrities and tags like “too posh to push”.  Advocates for natural birth argue that doctors are allowing women to have c-sections more out of convenience than necessity.  That is not the case.  Elective c-sections represent only a small percentage of births.  The vast majority of c-section births are for medical necessity. Even most scheduled c-sections are scheduled in advance because the doctor believes it is the safest option. Many women have prior experiences or complications that can help determine in advance if a vaginal birth is safe.

medical reasons for a c-section

There are Differences in Breastfeeding

The mode of delivery can impact breastfeeding.  Having a c-section can make it more difficult to breastfeed.  Women who have a c-section are in recovery for a period of time after delivering and miss what is commonly known as the “golden hour”, or the first hour of life.  During the first hour, newborns have a natural instinct to latch.  Nursing immediately after delivery can also help the mother’s milk come in.

Moms who deliver via c-section can, and do, successfully breastfeed, it just may take more time and effort to get into a stable routine. If you have concerns about breastfeeding, talk to your doctor. There are excellent resources available, and you can work with a lactation specialist if you need help or support.

Your Insides Can “Fall Out” after Natural Childbirth

After a natural birth, women may find that their internal organs shift, and in some cases, can even fall out (prolapse).  Natural birth is incredibly hard on a woman’s body, and uterine prolapse is a complication that happens to many women.

uterine prolapse

Uterine prolapse happens when the uterus falls into the vagina due to the pelvic floor muscles and ligaments becoming too weak to support the uterus.  Other organs, such as the bladder, may also fall lower in the pelvis.  This is incredibly uncomfortable and painful.  Some women require surgery to correct uterine prolapse.

Avoiding surgery by choosing natural birth does not always mean that surgery is ultimately out of the question. If your body goes through trauma or your organs are affected, you may still need surgery, even if you have a vaginal delivery.

You Might Need Stitches

In the debate about natural birth versus a c-section, many women argue in favor of natural birth because it doesn’t require stitches.  That may be true on the abdomen, but even natural birth may require stitches.  The majority of women, in fact, who have natural births require some form of stitches to the genitals due to tearing.  Some women require medical cutting, or an episiotomy, to allow more room for the baby to be born.

An episiotomy is an incision made between the opening of the vagina and the anus. This area is called the perineum. If your vaginal opening is too small to deliver the baby, or does not stretch adequately, doctors will make an incision here to allow more room for childbirth. This is especially common in cases where the mother’s pelvic area is small proportionate to the size of the baby. An episiotomy is preferable to the alternative, which is the tissue tearing from stress. This can cause bleeding and other potential issues.

C-Sections May Cause Changes in Fertility

Women preparing to give birth often don’t think about future pregnancies or births.  However, the decisions that women make in their current pregnancy could affect future fertility.  Women who have a c-section are more likely to experience changes in fertility (i.e. infertility).  This is because of scar tissue and damage to the uterus during surgery.  Women who have a c-section are also more likely to experience conditions like endometriosis, which can require additional surgeries and also impacts fertility and future pregnancies.

Women who experience painful periods, excessive bleeding, pain during sex and painful bowel movements or urination should talk to their doctor about endometriosis. Endometriosis is a difficult condition to diagnose, and sadly, most women wait for years before an adequate diagnosis is made and treatment begins.

Natural Breech Delivery is Dangerous

One of the most common reasons why doctors recommend a c-section over natural vaginal birth is when the baby is in a breech position at 39 weeks or at the time of delivery.  Breech position means that the baby is positioned feet-side-down in the birth canal.  Delivering a breech baby naturally increases the risk of birth injuries, such as oxygen deprivation or brain damage.

It can be difficult for mom’s to agree to a c-section, but in this situation, it is the best and safest thing for the baby.

Vaginal Birth After C-Section May Not be an Option

Many women who have c-sections during a first pregnancy will try to have a vaginal delivery in subsequent pregnancies.  This is referred to as a vaginal birth after c-section, or VBAC.  According to the Centers for Disease Control and Prevention (CDC), only 13 percent of women who have had a previous c-section will attempt a VBAC. Unfortunately, many VBAC attempts are unsuccessful.  Doctors will sometimes allow women to try natural birth, but should be prepared for surgery if needed.

It is estimated that 60-80 percent of VBAC’s are successful. There are a variety of factors that may prevent some women from even attempting a VBAC, however. Not all doctors or hospitals are equipped to perform VBACs. Some doctors and hospitals are unable to perform emergency c-sections should the VBAC be unsuccessful. Because of limitations, some hospitals simply will not do a VBAC.

The reasons why VBAC’s are sometimes unsuccessful vary, but generally are due to medical factors, such as:

  • Age
  • Scar tissue
  • Location of previous abdominal surgery scars
  • Uterine rupture
  • Previous c-sections
  • Large infant size
  • Gestation past the due date
  • Slow or difficult labor
  • Stress the woman’s body has already been through

Planned C-Sections Can be Emergent

Planning a c-section is a great option for women who have complications or certain medical conditions.  Planning ahead is also helpful for couples with older children and careers.  However, even the most well thought out c-section plan can still go awry.  There may be complications, or the mother may go into labor before the scheduled delivery.  Always remember that scheduling is not guaranteeing when the baby will arrive.

The Baby’s Size Impacts Delivery

The size of your baby can have a big impact on your delivery experience.  Babies that are very large may not be able to fit through the birth canal.  During vaginal birth, this can result in the baby getting stuck, which can cause injuries or oxygen deprivation.  If your baby is very large, your doctor may suggest a c-section to ensure a safe and healthy delivery. Sometimes, vaginal delivery is attempted, with doctors on standby in the event a c-section is necessary.

A Natural Birth Does Not Guarantee Safety

Surgical procedures have certain risks due to the procedure, sharp objects, and anesthesia or medications.  However, birth injuries are more common during natural birth.  Natural birth is difficult for the baby, and the process of delivering can result in injuries as minor as bruising, or may be more severe, such as newborn shoulder dystocia or a brachial plexus injury.  In the most severe cases, difficult natural birth can lead to injuries so severe that the baby doesn’t survive.

C-Sections May Cause Difficulty Breathing

Babies who are born via c-section may have difficulty breathing right after birth.  In many cases, this is because the baby already had difficulties with breathing or heart rate prior to delivery.  Doctors also attribute this to the fact that a c-section skips the part of labor where the baby generally clears his or her lungs of fluid. Doctors are generally aware of this and are able to monitor the baby’s breathing and vital signs during delivery.

Any Type of Birth Can Result in Incontinence

Some women argue that having a c-section is preferable because it eliminates the chance of urine leakage so commonly reported among natural birth moms.  However, that is not always the case.  Bladder incontinence can happen as a result of vaginal birth or a c-section.  It can be caused by hormonal changes, damage to organs and prolonged pressure on the bladder during pregnancy.

Blood Clots are a Risk of C-Sections

Blood clots are a risk after any type of major surgery.  Clots that develop in the legs or pelvic area are especially dangerous, and are the most common that travel to the lungs.  After a c-section, doctors should be careful to monitor for signs of blood clots and take preventative measures.

Natural Birth Recovery is Aided by Endorphins

The natural birth process is more physically straining on women, but the recovery is often easier than that of a c-section.  That is because during natural birth, hormones change and endorphins are released.  Similar to exercising, endorphins boost mood and provide energy.  This helps moms recover and strengthen quickly after delivery.

C-Sections Cause Health Problems Later in Life

There is no guarantee that a c-section will cause health problems later in your child’s life.  However, your doctor or pediatrician should talk to you about the possibility.  Some research has shown that babies born via c-section have a greater risk of developing asthma than those born via natural birth.  Studies suggest this is because during natural birth, the baby is exposed to natural bacteria in the birth canal, whereas babies born via c-section are not.

Natural Birth Can Cause Pelvic Floor Problems

During natural childbirth, the pelvic floor muscles get lax, stretched and sometimes bruised.  This can cause prolapsed organs and persistent back problems.  Sometimes these problems resolve on their own in time, and sometimes they require surgical treatment.  Some women have found that their quality of life has been permanently impacted.

Natural Birth is Dangerous for Multiples

One of the reasons that c-section rates have increased in recent years is attributed to the fact that multiple birth rates have also increased.  Delivering multiples (twins, triplets, etc.) naturally can be dangerous.  Multiples are more likely to be breech, and there is a greater chance of the umbilical cord becoming tangled.  There is also an increased risk of oxygen deprivation as the birth process may take longer.

Postpartum Depression is More Common after a C-Section

Having surgery is never easy, and when that surgery involves your unborn child, the process can be even more traumatic.  Hormone changes after delivery can cause any new mom to experience postpartum depression.  It is more common among women who have had c-sections.  This is attributed to factors including the stigma on c-sections and many women feeling judged or inadequate.  Further, recovery is typically longer, which makes new moms feel more stressed.

Doing What is Best for Your Family

Regardless of how you deliver your baby, the most important thing is that you and your newborn are safe and healthy.  There will always be stigma around certain choices and procedures, but the decisions you make for your family are personal and should always be made in your best interests.

If you have questions or concerns about healthcare, your rights as a patient, or birth injuries described in this article, contact Birth Injury Guide to learn more.

Maia Watkins

Page Medically Reviewed By Maia McSwiggan, MS, OTR/L

Maia McSwiggan, MS, OTR/L, is an occupational therapist with experience in the clinical and hospital settings. Maia has extensive experience working with children. She is a regular medical reviewer for Birth Injury Guide.

Meagan Cline

Written By Meagan Cline

Meagan Cline is a professional legal researcher and writer. She lends her expertise to the team at Birth Injury Guide to provide up-to-date and relevant content that clients can count on.