Babies can enter this world in one of two ways: vaginal birth or surgical delivery by cesarean section.
Babies can enter this world in one of two ways: a vaginal birth or surgical delivery by cesarean section. The ultimate goal of both methods is to ensure that the baby and mother are healthy.
In some cases, a C-section may be expected and thus scheduled in advance — for example, in the case of twins or other multiples; a medical condition, such as diabetes or high blood pressure; an infection that could be passed along to the baby during birth, such as HIV or genital herpes; or problems with the placenta.
A C-section may also be necessary if the baby is very large and the mother has a small pelvis, or if the baby is not in a heads-down position and efforts to turn the baby into this position before birth have been unsuccessful.
Sometimes an obstetrician decides to perform an emergency C-section because the health of the mother, the baby, or both is in jeopardy. This may occur because of a problem during pregnancy or after a woman has gone into labor, such as if labor is happening too slowly or if the baby is not getting enough oxygen.
Some C-sections are considered elective, meaning they are requested before labor. Someone may choose to have a C-section to plan when to deliver or if they previously had a complicated vaginal delivery. But if someone is eligible for a vaginal delivery, there are not a lot of advantages to having a C-section, said Dr. Allison Bryant, a maternal-fetal medicine specialist at Massachusetts General Hospital in Boston.
Although C-sections are generally considered safe and, in some situations, lifesaving, they do carry risks. The procedure is a major surgery and involves opening up the abdomen and removing the baby from the uterus. Because first-time C-sections often lead to C-sections in future pregnancies, a vaginal birth is generally the preferred method of delivery for first pregnancies. About 2 in 3 babies in the United States are born via vaginal delivery, according to the National Center for Health Statistics.
Vaginal birth in people who have previously had a C-section, whether elective or because of an emergency, may be contraindicated depending on the location of their C-section incision and risk of uterine rupture in which the uterus bursts open along the old cut, according to the Royal College of Obstetricians and Gynecologists. This type of birth is known as Vaginal Birth After Cesarean (VBAC). However, not all hospitals are not equipped to deal with VBAC complications and some doctors refuse to oversee them, said Dr. Patricia Santiago-Munoz, a high-risk pregnancy specialist in the Department of Obstetrics and Gynecology at University of Texas Southwestern Medical Center in Dallas.
Regardless of how they give birth, “women should be as informed as possible about their childbirth options so they can have a voice in the process, advocate for what they want and make the most informed choice,” Bryant said. Here is more information about the pros and cons of the two birthing methods.