What are the risks and benefits to giving birth naturally vs a caesarean?

As an expectant mother, it is easy to feel overwhelmed by the avalanche of information you will receive about ‘the best’ way to give birth.

This guide will cover:

• The risks and benefits of natural birth,
• The risks and benefits of caesareans,
• Different types of caesareans,
• When caesarean’s may be chosen or needed.

The term ‘natural birth’ is often used to describe vaginal birth. However, whether you have a vaginal birth, you opt for a caesarean section (c section), or you need an emergency c section, it is important to remember that all methods of giving birth are ‘natural’ and valid. While some people claim that vaginal births are the best option, there are risks, particularly for mothers with health conditions or who are going through difficult pregnancies.

Ultimately, you should choose the method that is best for yourself and your baby with the advice of your GP, midwife, obstetrician and other healthcare advisors. It is also the responsibility of your healthcare advisors to ensure that you are aware of the risks and benefits associated with different birth options and recommend the best course of action so you can make an informed decision about how to give birth.

What are the benefits to a mother of giving birth naturally?

Typically, if mother and baby are healthy, the baby is positioned correctly and is ready to be delivered from at least 37 weeks, a vaginal birth can have many benefits, such as:

Mother (and baby) will avoid the risks of surgery – Many people falsely assume that a c-section is the ‘easy’ option. However, a c section is a surgical procedure and just like any other surgery, c-sections are not without their risks. Infections, post-partum haemorrhage, blood clots and reactions to anaesthesia are all rare but possible risks.

Lower risk of scarring – C-sections involve a surgical incision to the mother’s stomach which can result in a scar. Vaginal births (although they carry their own risks) do not result in scarring the stomach.

Shorter hospital stay and faster recovery – For many women, having a vaginal birth is faster and easier to recover from than having a c-section. You usually don’t have to stay in hospital as long and you can get back to normal activities much sooner, for example driving.

Other benefits – Some research also suggests that mothers who have a vaginal birth find it easier to start breastfeeding and release positive hormones that help them bond with their baby.

What are the benefits to a baby of natural birth?

While your medical professionals will always do their best to ensure the health and safety of your baby, there are some benefits to your baby through this method of birth.

Supported immune system – During a natural birth, the baby will be exposed to helpful bacteria that can contribute to building up the baby’s immune system.

Improvement in breathing – The physical compression during a vaginal birth can help squeeze fluid from the baby’s lungs, reducing the risk of respiratory distress.

Alertness – Babies who arrive naturally are generally more active and alert, which makes immediate bonding, such as skin-to-skin, easier.

What are the risks of natural birth to a mother?

There are many reasons why a person may choose not to give birth naturally or is unable to have a vaginal birth. Sometimes, the risks of going through vaginal childbirth simply outweigh the benefits. These risks include:

Perineal tears or episiotomy – Sometimes the area between the mother’s vagina and anus can tear during the delivery. To prevent tearing or to speed up the delivery, the doctor may make a small cut to this area to allow more space for the baby to come out (they should always discuss this with the mother first).

Medically assisted births – Tools used in assisted births carry risks of injuries to the mother such as tearing, blood clots and incontinence. Your healthcare professionals should always inform you of the risks before proceeding.

Breech or transverse births – This is where the baby is positioned incorrectly, either feet first or on their side. This can make delivery more difficult and if it is not possible to turn the baby before birth, it is often safer to perform a c section rather than attempt a vaginal birth.

High blood pressure – This isn’t always a risk; however, high blood pressure is associated with some serious conditions, including pre-eclampsia and eclampsia which can be extremely serious or even fatal if not spotted and handled properly pre-labour and during childbirth.

What are the risks of natural birth to a baby?

Oxygen deprivation – A baby who does not get enough oxygen at birth is at risk of a number of conditions, including cerebral palsy, epilepsy, autism and developmental issues. These are serious conditions that last a lifetime. Oxygen deprivation can have many causes, including umbilical cord issues, prolonged delivery, and abnormal blood pressure in the mother. In most cases, if the doctors are able to spot the issues and act fast, the negative impact of oxygen deprivation can be limited, for example, by carrying out an emergency c-section.

Forceps or ventouse injuries – Forceps are metal instruments that are used to gently pull the baby out where labour is progressing too slowly or the baby is stuck. A ventouse is a suction cup that attaches to the baby’s head to assist their progression down the birth canal.

There are many other factors that may make a natural delivery riskier to both mother and baby, for example:

• If the mother is over 35 years old
• If the mother has previously had surgery on their uterus, such as a previous c section (this risk is referred to as vaginal birth after caesarean delivery or VBAC delivery)
• If the mother has medical conditions, such as diabetes or blood clotting issues
• If the mother is carrying more than one baby
• If there have been complications during pregnancy, such as growth issues or placenta issues

Vaginal birth or c section? Your right to choose

There are three situations in which you might have a caesarean section over a vaginal birth:

1. Elective caesarean – If you or your baby have health issues during pregnancy your midwife or obstetrician might recommend a c section
2. Emergency caesarean – If you have issues during labour and there are risks to you and/or the baby, you may need an emergency c section
3. Maternal request caesarean – This is where you request a c-section yourself over a vaginal birth for personal reasons. If there are no clinical reasons to perform a c-section then the hospital may refuse, although they must have a valid reason for refusal. For example, anxiety over giving birth may be a valid reason to have a c section so the hospital cannot refuse simply because it is not a ‘physical reason’.

In all situations, your GP, your midwife, your obstetrician, or other healthcare professionals have a duty of care to give you advice about the benefits and risks of giving birth naturally and of having a c section. You have the right to make an informed decision after receiving advice that is specifically tailored to you and your baby.

Benefits of a c-section

Caesarean’s, while bringing their own risks, can be the safest way to have your child and can be your only option. If you have a caesarean, elective or otherwise, the benefits can include:

Reduced damage to the pelvic floor – in a c-section there is a lower risk of urinary or faecal incontinence, as well as pelvic prolapse when compared to vaginal delivery.

Predictability in elective caesareans – If you are particularly anxious about giving birth, an elective caesarean can allow you to feel more in control of the situation. You can discuss beforehand when you will give birth and talk through the process more in depth with your medical professionals.

Lower risk of infection – In certain instances of infections, such as HIV or genital herpes, a c-section significantly reduces the risk of this passing to your baby.

Risks of a c-section

Caesarean’s are generally considered a safe surgery but they do pose their own risks including:

Infection – There is a higher risk of infection of the incision made to deliver the child, the uterus lining called endometritis, or infection of the urinary tract.

Blood Loss – With c-sections there is a higher risk of significant bleeding which could require a blood transfusion.

Longer Recovery – Caesarean’s require longer hospital stays (approx. 4 days vs. 2.5 for vaginal) and then a 6–8-week recovery period out of hospital.

Maternity care negligence

Where a healthcare professional fails to inform you of any risks or issues and you suffer harm as a result, this could be medical negligence and you could be entitled to make a compensation claim. For example, if you opt for a vaginal birth not knowing there are high risks involved and your baby is born with serious health conditions as a result, this could be medical negligence.

Similarly, if a healthcare professional fails to spot risks and issues associated with having a vaginal birth or c section and you and/or your baby suffer harm as a result, this can also amount to medical negligence. For example:

• If your midwife fails to notice that your baby is breeched resulting in you and/or your baby being injured during a vaginal delivery
• If an obstetrician opts for forceps when an emergency c section would be more appropriate resulting in you and/or the baby being injured

Birth injury legal experts

At Fletchers, our team of leading medical negligence solicitors regularly help individuals claim compensation for injuries caused to mother and/or baby during childbirth. We are top ranked by prestigious client guides, Chambers and Partners and the Legal 500 for our skills in this area.

We can investigate your claim on your behalf, assess your needs and how much compensation you could claim, conduct the proceedings, and liaise with the negligent healthcare provider on your behalf to try to agree a settlement. We secure millions of pounds worth of compensation for clients every year.

So, for expert advice about birth injury compensation claims, speak to us today.