Caesarean versus Natural Birth- what’s the difference?
April is Caesarean (C-section) Awareness month, organised by The International Caesarean Awareness Network. In this article we look at what happens when your baby is born via a c-section, and the things you need to know about the choice between a c-section and a natural birth.
What is a C-section?
A C-section is where a surgeon makes a cut in the abdomen and womb to deliver a baby. Around 25% of pregnant women in the UK have a C-section, whilst 75% give birth by vaginal delivery.
When is a C-section performed?
There are 3 circumstances when a C-section might be carried out.
An emergency C-section may be carried out if yours or your baby’s health is threatened, and the baby needs to be born urgently. For example, where the baby is feet first or is not getting enough oxygen.
You may be advised to have an elective C-section if there are higher risks to vaginal birth and a doctor thinks it would be safer for your baby to be delivered by C-section. For example, if your baby is particularly large or you have pregnancy-related diabetes.
Maternal request C-section
Finally, you might request a C-section yourself, known as a maternal request C-section. Although there is no legal right to have a C-section in the UK, it is a mother’s choice to decide the way they give birth.
Understanding the Debate
There is ongoing debate about the pros and cons of C-section versus vaginal delivery. The key issues around the two different kinds of birth are:
C-section – a major operation, with potential complications for mother and baby. Possible maternal difficulties include excessive bleeding, infection or blood clots, whilst risks to the baby include breathing difficulties after delivery or accidentally cutting their skin.
Vaginal delivery – not without risk, but a C-section will not usually be offered unless it is the safest option for you and your baby. Surgical delivery offers a higher degree of control over your labour, and failing to perform a C-section where one is required can have devastating results for mother and baby – most seriously death or brain injury.
Making an Informed Choice
The decision about whether C-section or vaginal delivery is best will depend on your individual circumstances. You should always ask your midwife or doctor if you have any concerns about your birth plan or want to discuss the pros and cons of having a C-section for your delivery.
For an elective or maternal request C-section, your doctor or midwife will be able to help you make an informed decision about the delivery method beforehand. Emergency C-sections on the other hand are unplanned. However, your doctor should still explain the reason they recommend an emergency C-section and obtain your informed consent where possible.
Your Right to Choose
The NICE guidelines state that mothers should always be given the option to deliver their baby via C-section if they wish. Unfortunately, this is not always implemented consistently, and some Trusts are better than others at offering mothers a choice.
Sadly, there is also evidence that black women are rarely being given the information they need to make informed decisions about their birth options. The ongoing Health and Social Care Committee Inquiry into Safety of Maternity Services in England found that just 27% of black women were presented with the option of having a C-section. This is particularly concerning following the 2018 MBRRACE report findings that black women are five times more likely than white women to die in childbirth.
For more guidance on your rights in pregnancy and childbirth, we recommend the helpful factsheets from UK charity Birthrights. Alternatively, if you think that you or your baby have been injured as a result of a C-section, or a failure to perform a C-section, you can speak to one of our birth injury solicitors about this today.