If you’re considering an elective C-section, here’s what you can expect from a C-section versus a natural birth.
When it comes to giving birth, we all have the same goal: Get the baby out! How we accomplish that is sometimes a personal choice and other times a medical necessity.
If you’re pregnant and trying to decide which option is best for you — a natural birth (aka vaginal delivery) or cesarean delivery, which is also known as a C-section or cesarean section — there are some key differences to consider, as well as questions you should ask your doctor.
This article reviews each birthing option, their associated healing and recovery times, and risks and complications. To help you get a better understanding of what it’s like in the delivery room, we also talked to two women who’ve experienced both a C-section and vaginal birth.
For the sake of this article, a “natural birth” is considered a vaginal delivery, which could be with or without pain medication or other medical intervention.
Typically, vaginal births result in shorter hospital stays, lower injection rates, and quicker recovery times. Some women will deliver a baby with no medical interventions, while others may require or request some form of intervention. These may include:
- pitocin to induce labor
- an episiotomy (a surgical incision) to allow the baby’s head to pass through without tearing the skin
- an amniotomy or artificial rupture of the amniotic membranes (breaking your water)
- a forceps delivery or vacuum extraction
The other delivery option is a C-section, which is a surgical procedure to remove the baby when a vaginal delivery isn’t possible or not requested by the mother. A C-section can be planned or medically required.
While they’re not as common as vaginal births, the American College of Obstetricians and Gynecologists (ACOG) says certain situations make a cesarean necessary. These include:
- medical concerns for the baby
- being pregnant with more than one baby
- problems with the placenta
- labor isn’t progressing in a timely manner
- the baby is large
- breech presentation
- maternal infections or conditions, such as high blood pressure or diabetes
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If you’ve had a C-section, are pregnant again, and a good candidate, your doctor may talk to you about a vaginal birth after cesarean (VBAC). According to the ACOG, women who’ve had a C-section have two choices with future births: a scheduled cesarean delivery or vaginal birth.
That said, women at a higher risk of uterine rupture aren’t good candidates for a VBAC. If your uterine incision is a low or high vertical cut, your doctor may advise you not to go the VBAC route. Both of these incisions carry a higher risk of rupture than low transverse or side-to-side cuts made across the lower part of the uterus.
Sometimes a VBAC is attempted but not successful, and the doctor performs a cesarean. The ACOG calls this a trial of labor after cesarean (TOLAC).
Vaginal deliveries can happen in the hospital, a birthing center, or at home. Some women ask for pain medicine, such as an epidural, to help manage their labor pain.
You can expect to move through three phases of labor: early, active, and transitional (or first, second, and third stage). A nurse or doctor will periodically examine you to see where you are in the stages, which includes measuring your cervix.
When you reach 10 cm, you’re fully dilated, and it’s time to push. Your medical team will assist as you push and the baby moves down the birth canal. Once the baby crowns and is delivered, you’ll still have minor contractions as you prepare to deliver the placenta.
Cesarean birth is quite different from a vaginal delivery. In general, a C-section is a surgical procedure that takes about 45 minutes, whereas a vaginal birth can take hours. For this type of birth, your doctor will make an incision through your abdomen and uterus to remove your baby.
Once baby is out, your doctor will cut the umbilical cord, remove the placenta, and close the incision. Since this is an operation, you’ll be given a spinal anesthesia or an epidural if you are already in labor. General anesthesia is only used in case of emergency, for example if your platelets are too low.
If your doctor opts for the latter, you won’t be awake. Conversely, an epidural block, which numbs the lower part of your body, allows you to remain awake during the procedure.
After a cesarean delivery, your medical team may need to check your baby and clear their airway before allowing you to hold your baby. While you’ll be united as soon as possible after birth, it may not be immediate like in a vaginal delivery.
Doctors call the first 6 weeks following delivery the “recovery period” for a reason. It’s during this time that your body needs to rest and heal from the stress of childbirth.
Your healing and recovery from a vaginal delivery will depend on which, if any, medical procedures were performed during birth. For example, if you tore or needed an episiotomy, healing and recovery will most likely take the full 6 weeks. It will also be more painful and require some adjustments in your daily routine.
Mamas who delivered without a perineal tear or episiotomy may feel better within 3 weeks or less. Regardless, most women will experience perineal soreness and bleeding for at least 1 to 2 weeks.
According to the ACOG, recovery from a C-section is similar to that of any surgery. You’ll need to stay in the hospital for the first 2 to 4 days after the procedure. Moving around, including getting in and out of bed, is often difficult and quite painful.
In the first few weeks, you may notice that your scar is itchy or painful. This is part of the healing process. You may also experience mild cramping, bleeding, or discharge for about 4 to 6 weeks. Your doctor will reassess your progress at your 6-week appointment to determine what activities you can resume.
But which recovery will be easier?
In general, the healing and recovery time for a vaginal birth is often significantly faster than that of a C-section. That said, some women experience the opposite.
Melinda Ashley, mother, parenting expert, and founder of Unfrazzled Mama, had an unplanned C-section for her first birth and a VBAC for her second.
For this mama, her C-section recovery was actually much easier than that of her VBAC. “I felt great just a few days after my C-section, and I was even ready to start exercising a few weeks later.”
The fact that she needed an episiotomy was what made her VBAC more challenging to recover from. “It hurt to use the restroom, it hurt to sit down, it hurt to stand. The pain persisted for weeks, and it took much longer for me to get back to my regular activities.”
That said, Ashley thinks if she hadn’t had the episiotomy, the vaginal birth would’ve been easier to recover from, and she would’ve been back to normal in a much shorter time frame.
For Jaimie Zaki, her two VBAC births were much easier than her cesarean. “I’ve experienced both VBAC with an epidural and an unmedicated VBAC, and I’d say my unmedicated was even easier than my medicated. For me, the recovery with my unmedicated vaginal birth was mostly a breeze with the least tissue trauma of all my births.”
It’s important to know that every body is different, and every birth is different. Oftentimes, subsequent births offer easier recoveries, but not always.
Both vaginal deliveries and C-sections come with risks and potential complications. Women who deliver vaginally can experience perineal tears or need an episiotomy that requires stitches and several weeks of healing time. Additionally, many women will experience issues with bladder control or an organ prolapse after a vaginal birth.
And similarly to other major surgeries, a cesarean has potential risks and complications. According to the ACOG, problems can occur with infection, blood loss, blood clots, injury to the bowel or bladder, and reactions to the anesthesia or medication.
If you have questions about each type of delivery, make sure to talk to your doctor during your routine prenatal visits. They can help you understand which option is best for you.
Creating a birth plan that outlines your goals for labor and delivery can help you prepare for childbirth. And whether that involves a vaginal delivery or C-section, the end goal is to deliver a healthy baby.