C-sections, also known as Cesarean sections, have become an increasingly popular method of childbirth in recent years. There are several reasons why C-sections may be a better option than vaginal delivery for some women. In this article, we will explore the potential benefits of C-sections.
Lower Risk of Incontinence and Prolapse
One of the most commonly cited advantages of C-sections is the potential reduction in risk of urinary incontinence and pelvic organ prolapse later in life. Vaginal births can sometimes damage muscles and nerves in the pelvic floor, leading to a dropped bladder, uterus or rectum. C-sections avoid the stretching and trauma associated with vaginal delivery and are therefore thought to reduce the chances of developing these problems.
According to a 2012 study published in the American Journal of Obstetrics and Gynecology, the rate of urinary incontinence was 22% lower in women who had C-sections compared to those who delivered vaginally. The rate of pelvic organ prolapse was also 29% lower.
Avoids Labor and Delivery Complications
For some women with pregnancy complications, a C-section is recommended to avoid dangerous labor and delivery issues. These include:
- Placental problems like placenta previa where the placenta covers the cervix
- Prolonged labor or failure to progress
- Fetal distress
- Breech position of the baby
- Umbilical cord issues
- Multiple births
A C-section avoids the stress and risks associated with these complications and allows the delivery to proceed in a controlled fashion under the safest conditions possible.
Convenience and Predictability
While not a medical reason per se, the convenience and predictability of scheduling a C-section birth is preferred by some women. Due dates are just estimates, so there is no guarantee that labor will start when expected. With a planned C-section, the date and time is known in advance. There is no mystery about when the baby will arrive or worry about going into labor prematurely or late.
In our increasingly impatient society, being able to plan and control the birth experience is a plus for some women. Avoiding the painful uncertainty of labor allows them to feel calm and prepared.
Reduced Likelihood of Needing an Emergency C-Section
While aiming for a vaginal delivery, approximately 25% of women end up needing an unplanned, emergency C-section during labor if complications arise. Emergency C-sections are associated with higher risk of complications compared to planned procedures. Opting for a scheduled C-section avoids the possibility of needing an emergency one later.
Shorter Recovery Time
Research indicates that women who deliver vaginally have increased postpartum pain and slower resumption of full activity compared to C-section births. One study found the average time until women felt fully recovered was 2 months after a vaginal delivery versus 6 weeks with a planned C-section. Less labor trauma results in shorter recovery times.
Lower Risk of Death and Severe Health Issues in Certain Cases
For women with high risk pregnancies involving conditions like gestational diabetes, preeclampsia, high blood pressure, blood clotting disorders, prior uterine surgery and older maternal age, studies indicate planned C-sections may reduce the risk of neonatal and maternal death and health complications like hemorrhage and sepsis.
However, the reduced risks associated with planned C-sections in high risk women do not necessarily apply to low risk pregnancies. The benefits vs harms must be carefully weighed by each woman and her doctor.
Allows Further Future Pregnancies
Rarely, severe vaginal tears or injury during labor and delivery can damage the reproductive system and make future pregnancies impossible. By avoiding labor completely and delivering via C-section, this possibility is eliminated.
Reduced Risk of Pelvic Floor Dysfunction Later On
As mentioned earlier, vaginal delivery increases the possibility of pelvic floor issues down the road like urinary incontinence and pelvic organ prolapse. C-sections avoid the rigorous stretching and compression that can weaken pelvic muscles and connective tissue over time.
One Australian study tracked women for 30 years after giving birth. At the end of the study period, pelvic floor dysfunction was 64% higher in the vaginal delivery group compared to those who had C-sections.
Lower Incidence of Postpartum Depression
Some research indicates women who deliver via planned C-section have a lower incidence and severity of postpartum depression symptoms compared to women who deliver vaginally. It is thought that avoiding labor, the pain of vaginal childbirth and exhaustion from pushing contributes to better emotional health post-delivery.
Decreased Likelihood of Bowel Incontinence Issues Later On
Damage to the anal sphincter muscles sometimes occurs during vaginal delivery, particularly if an episiotomy is performed or extensive vacuum or forceps intervention is needed. Later in life, this can result in an increased likelihood of bowel incontinence. Since the sphincter area remains undamaged with C-section, it reduces the future chance of this embarrassing issue.
Lower Risk of Postpartum Hemorrhage
While rare, significant blood loss (postpartum hemorrhage) can happen after vaginal delivery as the uterus contracts and blood vessels that had opened up during pregnancy close back down. By avoiding labor and the contractions that control blood loss, planned C-sections lower the risk of hemorrhage-related complications.
Consistent Experience for Subsequent Births
If a woman’s first birth is via planned C-section, evidence shows that planned C-section for future births results in the best outcomes. Trying for a vaginal birth after previous C-sections (called VBAC) has higher risks. Once a C-section, always a C-section allows for a predictable birthing experience each time.
Better Outcomes for Breech Babies
Babies in the breech (bottom down) position often require emergency C-sections when vaginal delivery is attempted. Planned C-sections for known breech babies results in fewer delivery complications and better health outcomes.
Smaller Chance of Needing Additional Surgeries Later On
Vaginal births carry a risk of pelvic floor complications that may require corrective surgery later in life, like anterior or posterior repair for organ prolapse. C-sections avoid the possibility of needing these additional pelvic surgeries down the road.
Less Chance of Passing GBS to the Baby
Women who test positive for Group B Strep (GBS) have a 1 in 200 chance of passing it to the baby during delivery with standard antibiotic treatment. That risk drops to 1 in 4000 with a planned C-section because the baby avoids contact with the birth canal altogether.
Key Takeaways on Why C-sections Might Be Better:
- Lower risks of pelvic floor issues like urinary incontinence and organ prolapse
- Avoid dangerous labor and delivery in high risk pregnancies
- More convenient and predictable birth experience
- Shorter recovery times
- Reduced risk of needing emergency C-section
- Better outcomes in certain cases like breech position
Reasons Why Vaginal Delivery May Still Be Better
While there are certainly many potential benefits to elective C-sections, for low risk pregnancies, the advantages of vaginal delivery often still outweigh surgery. Here are some reasons why, for many women, aiming for a vaginal birth may lead to the best results:
- Lower risk of surgical complications like infection, bleeding and negative reactions to anesthesia
- Quicker recovery and shorter hospital stay
- Greater initial bonding and breastfeeding success
- Allows the child’s lungs to fully drain of amniotic fluid
- Stimulates helpful hormone release and uterine contractions
- Lower risk of the baby experiencing respiratory distress
- No abdominal surgery scarring
- Reduced likelihood of the baby needing special care nursery
- Lower risk of the placenta adhering abnormally in future pregnancies
The above benefits are why vaginal delivery is still recommended as the preferred method of childbirth for most low risk pregnancies.
Risks and Complications of C-Sections
While C-sections are extremely safe in this day and age, they do still carry additional risks compared to vaginal delivery. Understanding the possible downsides is important when considering birthing options. Potential C-section risks and complications include:
- Infection (1-3% risk)
- Surgical injury to organs like bladder or bowel (less than 1% risk)
- Blood clots
- Adverse reaction to anesthesia
- Increased blood loss and need for transfusion
- Longer hospital stay
- Difficulty establish breastfeeding
- Breathing problems for the baby
- Baby less alert and slow to interact due to medication effects
- Longer recovery period
- Future pregnancy complications like uterine rupture or abnormal placenta attachment
- Scarring and potential for chronic pain at incision site
While many of these risks are small, they highlight why C-sections should not be undergone electively without a clear medical need. Vaginal delivery remains the safest option for low risk pregnancies. Weighing the benefits vs potential harms of both choices is something each expectant mom should do with her healthcare provider.
Conclusion
For women with high risk pregnancies or certain complicating conditions, planned C-sections often lead to the best health outcomes for both mother and baby. But for most low risk pregnancies, aiming for vaginal delivery is still the recommended choice in most cases. While C-sections should remain an option when their benefits outweigh the harms, they should not be undergone electively. Women should review all their options and preferences with their obstetrician when making a birthing decision.