Cesarean versus vaginal delivery – Which is best?

Until about 50 years ago the cesarean delivery rate was about 5%, but since the 1960s, it has steadily increased to about 1 in 3 now, though for the last 10 years that rate has remained steady.  About 1/3 of cesarean sections are done in women who previously had a cesarean, while 2/3 are done mainly for fetal distress, inability to deliver vaginally (“failure to progress”), and breech. There are often good reasons and indications to do a cesarean. In fact, studies have shown that in countries where cesarean delivery rates are too low (usually below 10%), there is an increase in maternal and neonatal mortality.

Risks for mom from cesarean

Going through labor and having a vaginal delivery can be a long process that can be physically taxing for the mother. A cesarean is a major surgery, and though the vast majority of cesareans can be done safely, there are certain risks to the mother such as blood loss, infection, anesthesia risks, and a longer recovery period. Some women and doctors assume that because the first baby was born via C-section that all of their children will have to be born this way to prevent the uterine scar from opening during labor. In addition, the next pregnancies have increased risks including “placenta accreta,” a serious condition where the placenta attaches or grows into the uterus, and threatens the mother’s life.

Risks for a baby born by cesarean

During labor and a vaginal birth, baby’s lungs get readied so there is a better chance to breathe oxygen after birth. Babies born via C-section often have respiratory issues with extra fluid in their lungs at birth because they don’t have the chance to undergo this process. During vaginal births, babies are also exposed to certain good bacteria (“microbiome”) which may boost the baby’s immune system.

A healthy baby and mother are the goal

In the end, the decision surrounding a vaginal birth or a C-section should focus on keeping mom and baby healthy. Sometimes there is a medical reason that a delivery doesn’t end up as a vaginal birth to keep either the mother or the baby safe. But to decide on a C-section for a non-medical reason may not be in the best interest of mom or her baby.

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