Updated: May 30, 2021
My name is Brittany Pompilii and my pronouns are she/her. I reside on the traditional territory of the Haudenosaunee, Anishinabewaki, Attiwonderonk, Mississauga, and the Mississaugas of the Credit First Nations peoples. This land is currently known as Niagara, Ontario. As the author of this post, I acknowledge that my privilege, and therefore my experiences, inform my perspectives on the Western healthcare system. Furthermore, I have never been pregnant or experienced childbirth, therefore, I do not intend to speak on behalf of women who have experienced pregnancy and childbirth. I do not have an educational or professional background in prenatal care, however, as a research team member, I am committed to using my research and writing skills to help all women access public health information - a right that all women are entitled to yet do not always receive. I hope that one day, the public health system represents all peoples’ experiences and treats all people equitably. With this post, I intend to provide accurate information to educate folks on vaginal births compared to Cesarean sections, so pregnant persons can make the best choice for their childbirth experiences. In any case, please contact your healthcare provider to discuss and advocate for your birthing decisions.
What is a vaginal birth?
A vaginal birth refers to delivering a baby through the vagina after going into labour (1*). The process of labour involves the pregnant person’s cervix widening (dilating) and thinning (effacing) to create space for the baby to move from the uterus through to the vaginal opening for birth. During labour, pregnant folks experience contractions as the cervix dilates and effaces. The contractions occur more frequently and intensely until the cervix is wide and thin enough for a baby to be pushed through (2*). On average, the cervix needs to be dilated at least 10 centimetres to deliver a full-term fetus (3*; 4*). Medical intervention can be administered for pain management during vaginal births (e.g. epidurals, episiotomy) (5*; 6*). Vaginal births vary in length of time, although first time deliveries usually take approximately eight hours or more (7*).
Vaginal births can be carried out by a variety of trained care providers, including (8*):
Maternal-fetal medicine specialists
A pregnant person can have a vaginal birth at home, at the hospital, a birth centre, or another safe place (e.g. a friend’s house). Not all pregnant folks have the option to decide where they give birth, as it depends on the pregnant person’s health, the risk of the pregnancy, and other situation-specific health and safety factors (9*). If there are no risks to the pregnant person or the baby’s health, vaginal births can occur in a space of the pregnant person’s choosing. Note: It is recommended that multiple pregnancies (e.g. twins, triplets, etc.) are delivered in a hospital setting due to higher risks of complications during labour & delivery (10*).
After a vaginal birth, the birthing person enters a postpartum period of recovery, and may be discharged from the hospital within 1-3 days after giving birth. Following childbirth, the birthing person may experience (11*; 12*):
Involuntary urination or bowel movements
Difficulty with movement
Mental health challenges (e.g. depression, anxiety, hopelessness)
This postpartum period can take up to, or over, a year for the birthing person to feel like they are back to their ‘normal’ self - emotionally, mentally, and physically. The birthing person can usually be cleared for exercise and/or sexual activity within a few months post-birth (12*).
An epidural is an anesthetic administered into a pregnant person’s lower spine during labour to reduce pain and discomfort during childbirth (5*).
An episiotomy is a surgical incision between the vaginal opening and the anus to enlarge the vaginal opening. This procedure can be requested by the pregnant individual to potentially avoid the discomfort of vaginal tearing during childbirth (6*).
What is a Cesarean section birth?
A Cesarean section (commonly known as C-section) is a surgical procedure to deliver a baby (or babies) through an incision in the abdomen and uterus. In some cases, a pregnant person can plan to deliver their baby via C-section; in other circumstances, a C-section is a required medical intervention during labour when a vaginal birth isn’t feasible (13*). An emergency or planned C-section can be required in situations of (13*; 14*):
Stalled labour (cervix isn’t dilating or effacing)
Baby is in distress or in an abnormal position for delivery
Delivery poses a health risk to the pregnant person and/or the baby
Placenta issues (e.g. placenta covering the cervix)
Birthing person’s pelvis is too small to deliver a baby vaginally
Chronic health condition (e.g. heart disease, HIV/AIDs)
C-sections are performed in hospitals by obstetricians. Obstetricians (also known as OBs or OB/GYNs) are doctors who are specialized in providing care during pregnancy and childbirth (15*).
After a Cesarean delivery, the birthing person can be discharged from the hospital within a few days, although it could be longer if there were complications. During postpartum recovery from a C-section delivery, it is important to take care of the healing incision. Following a C-section, the birthing person may experience similar symptoms and conditions as a person who delivered vaginally, however, the healing process is often shorter than a vaginal delivery. The only differences would be pain, redness, swelling or pus around the incision site, instead of pain around the vagina and anus. The average postpartum recovery period is six weeks (16*).
Vaginal Birth After C-section (VBAC)
A vaginal birth after C-section (VBAC) is possible for pregnant folks having more than one baby over time. However, it is recommended to have C-sections after a previous C-section delivery to minimize risks associated with VBAC, especially if the pregnant person could not undergo labour and vaginal birth before (17*).
Vaginal birth vs. C-section: Which birthing option is preferred?
In some cases, pregnant folks can decide whether they would like to deliver their baby (or babies) vaginally or by C-section. It is possible to plan out childbirth experiences by making a birth plan - check out our birth plan posts here and here. In the event that a pregnant person has the ability to choose between vaginal birth and C-section, which one should they choose?
The answer: It will depend on the pregnant individual and their baby’s health and safety.
The following section of this post will discuss choosing between vaginal births and C-sections under the assumption that there are no complications or health risks during pregnancy, labour, and/or childbirth. As previously mentioned, pregnant folks may require C-section deliveries, even if they planned on delivering vaginally, to protect their health and their baby’s health. Depending on the pregnant person’s circumstances, they will be informed ahead of childbirth that they will need to perform a C-section; in other cases, an emergency C-section is performed when vaginal childbirth isn’t safe or feasible (14*).
It is recommended to proceed with a vaginal childbirth if there are no complications with the pregnancy, as C-sections carry more risks and a longer recovery time for the birthing person, as it is a major surgery. However, one of a biggest reasons why pregnant folks may decide on an elective C-section is if they are experiencing distress and/or anxiety around vaginal birth (14*).
Pregnant folks may choose to deliver vaginally... to experience a vaginal birth (18*; 22*)! In general, vaginal births result in shorter hospital stays and quicker recovery periods than C-section births. If the birthing person is a parent, they may also prefer this option as they will be able to hold their baby shortly after the vaginal birth. This is positive for the baby, as they can connect with their parent as soon as possible and begin forming attachments (19*). Additionally, babies receive good bacteria from vaginal births, which have been proven to boost their immune system (20*).
Pregnant folks may not want to deliver vaginally to avoid pain associated with vaginal birth. During vaginal births, the birthing person’s vagina can stretch and tear, causing pain and discomfort, as well as a need for stitches and long-term healing. After birthing a baby, postpartum folks often experience pain in the vagina and anus, as well as involuntary bowel movements and urination (11*; 12*; 18*).
In cases where a C-section is not medically required, pregnant folks may choose to deliver by C-section to avoid the pain of labour and vaginal birth, both of which can be long-lasting and intense (21*). C-sections can also prevent oxygen deprivation of the baby that can occur during vaginal births. Additionally, postpartum birthing persons experience less involuntary bowel movements and urination and can engage in sexual activity sooner after birth than folks who deliver their baby vaginally (19*).
Pregnant folks may not want to undergo a C-section birth, as the recovery period and risk of complications is higher than vaginal birthing and can result in less favourable birthing and postpartum experiences (22*). In addition, after one C-section, it is recommended to subsequently deliver all babies via C-section, unless the pregnant person is cleared for VBAC by their doctor (22*). Choosing C-section births over vaginal birth is rare; in general, pregnant folks choose vaginal deliveries as it is associated with fewer complications, health risks, and quicker recovery periods (21*).
Overall, both vaginal births and Cesarean sections carry advantages and disadvantages, but the decision ultimately belongs to the pregnant person - if they have the privilege and option to choose. The best choice is what is healthiest and safest for the pregnant person and the baby - or babies!
*These sources do not specify the gender identity of the women included. Historical representation leads us to believe only cisgender women were included.
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