Natural birth or C-section and why?

Cesarean delivery (C-section) has become an increasing tendency among pregnant women, but a medical indication for C-section is present in only 15% to 20% of all cases. So, which one to go for, natural delivery or C-section?

For the health of both the mother and the baby, a decision to undergo normal or cesarean delivery must be made upon doctor’s consultation after careful diagnosis of the expectant mother and her yet unborn baby’s conditions.

Why natural birth?

Nature’s plan always makes sense, except for risky cases such as a mother with a small pelvis, or a too large baby (over 4,000 gram), or the baby not in normal position for delivery (e.g. a breech position or a transverse position). Natural birth has been proven to be beneficial for mothers and babies:

- Moms who experience natural childbirth are able to recover quickly, begin breastfeeding early (one hour after birth) and be up and walk around shortly after birth.

- Babies can be soon breastfed colostrum (within 72 hours after birth) from their mother. Colostrum contains many kinds of compounds that help protect and support babies’ growth and immunity.

- By giving birth naturally, mothers and babies are physically and emotionally prepared for the journey they will be going on together. Seeing her baby healthily lying next to her, the mother may feel peaceful, excited and proud of the miracle she has just got. The whole process gives her strong motivation to overcome all the challenges ahead.

Who should go for a C-section?

A C-section is needed in cases of emergency or when there are complications that make vaginal birth unsafe for the mom and her baby.

- A C-section is required when the baby is too large compared to the maternal pelvis. In this case, if going for a normal delivery, the baby’s shoulder can be stuck inside the mother’s body (shoulder dystocia), leading to brachial plexus paralysis, adversely affecting the child’s future development.

- A mother with narrow pelvic may have the risk of uterine rupture when entering normal labor. In cases of placenta previa, there is a high risk for massive blood loss; a cesarean is required, sometimes hysterectomy (removal of the uterus) is needed to stop bleeding.

- A cesarean section is safer for the baby in breech or transverse position.

- Immediate cesarean is required in emergency cases when fetal distress or loss of fetal heartbeat is suspected.

- Even when a mother is indicated to have natural birth, if umbilical cord prolapse occurs after the rupture of her amniotic sac, a cesarean is an absolute indication.

For those who are afraid of vaginal delivery

Elective cesarean section is indicated in cases of:

- Complete placenta previa.

- Mature fetus in women who had C-section(s) in the past.

However, it’s acceptable for women who worry about experiencing the pain of labor and wish to go for cesarean delivery as long as they are fully consulted by the doctor about complications associated with a cesarean delivery:

- The risk of complications from anesthesia (though the complication rate is low) : General anesthesia requires tracheal intubation which might cause aspiration pneumonia; spinal anesthesia might cause headaches or back pain later on.

- Cesarean delivery leaves wounds in the uterus and abdominal wall, posing the risk of infection.

To sum up, every decision to go for natural or cesarean delivery should be made after thorough consultation with the physician(s).

Prof. Tai Nguyen, MD. PhD.
Medical counselor, Obstetrics and Gynecology, American International Hospital (AIH)