Caesarian Section versus Vaginal Delivery -What's your Take?

In Nigeria, a lot of women are scared of C/S. If by any chance they are told by their doctor that they have to give birth by C/S, their first reaction is "God Forbid". Most women want to deliver "like the hebrew women" of the bible and they think to do this, it has to be by vaginal delivery. On the other extreme, though this is less common, there are women that opt out of vaginal delivery completely. They do not want the pain and stress associated with Vaginal delivery. However, it is necessary for every woman to be informed about the pros and cons of each route of delivery and make an informed decision from a place of knowledge and not fear or cultural beliefs. Also every woman and baby's circumstance is different and this informs choice of delivery. The ultimate goal is to give birth to a healthy baby, safely and this should be the main factor in deciding route of delivery.

Comparison of C/S and Vaginal Delivery.

• C/S is a surgical operation to deliver the baby from the abdomen by a trained personnel usually a doctor as opposed to vaginal delivery where baby is delivered naturally from the vagina with most effort from the mother.
• There are certain conditions that make a C/S compulsory such as medical conditions like Hypertension with pre-eclampsia, diabetes, a big baby when mother's pelvis is small, problems with baby's placenta, breech presentation, twin babies. 
• C/S carries more risk than Vaginal delivery as it is a major surgery and there can be complications of surgery like bleeding, infection, reaction to anaesthesia. However, all these are minimised by appropriate care and surgical skill. 
• Vaginal delivery also carries its own risk as repeated vaginal delivery can weaken the pelvic floor and predispose women to incontinence - Leaking urine or faeces when they cough or laugh.
• Vaginal delivery is usually more stressful for the mother as it is longer and more painful. It is also associated with more mental and emotional stress. C/S on the other hand is shorter, more straight forward and pain-less at the time, as anaesthesia is given. But when the anaesthesia wears off, the pain is more long-lasting.
• With a vaginal delivery you can leave hospital earlier compared to a C/S.
• C/S is safer for a baby as the baby avoids the stress of labour and the complications of a long, obstructed labour. However, vaginal delivery is safer for mother as she is 3-4 times more likely to die from a C/S than a vaginal delivery.
• Though an elective C/S is associated with better outcomes for the baby, research shows that babies born with C/S are more likely to have breathing problems and even Stillbirths.

The main message is that both routes of delivery have their advantages and disadvantages. C/S however carries more risk. But, there are some situations where a C/S may be the only option and may be life saving. It should not be rejected or feared because of false perception or cultural beliefs. The focus should be on giving birth to a healthy baby safely, irrespective of the route.
Till my next post, stay well, make an informed choice and stay healthy-pink.
Dr. Anire Oduko.





References

1. Baker P.N. (Editor) (2006) Obstetrics by Ten Teachers. 18th Edition. BookPower. London.
2. Nierenberg C. (2015) "Vaginal Birth vs C.section:Pros and Cons". Livescience. Available online at http://www.livescience.com/45681-vaginal-birth-vs-c-section.html