Why is it we think of vaginal births as the ideal way to give birth?
Why do we just assume vaginal birth is necessarily safer?
Why aren’t women told of the risks and possible compilations of vaginal births including tearing, haemorrhage and incontinence?
Why do we think vaginal births are the best thing for mother and baby?
Why do we assume vaginal birth is necessarily safer? Image via IStock.
That’s the subject raised by researcher Mairead Black from the University of Aberdeen.
Writing for The Conversation Ms Black says that hospitals still treat vaginal birth as the default birth mode for most women, despite its risks.
In fact 9 in ten women who have a vaginal birth will either suffer a tear to the genital region or require a surgical incision during delivery.
Black says that one in six women end up having an operative vaginal birth, such as use of forceps associated with faecal incontinence and pelvic organ prolapse in later life.
New Scientist pointed out in an article last year that a landmark Swedish study found that 20 years after giving birth, 40 per cent of women who had a vaginal delivery had some form of urinary incontinence, compared with 29 per cent who’d had a Caesarean.
While studies have shown that 95% of women aim for a vaginal birth in their first pregnancy, only around 75% achieve this.
Black writes that in fact 21% of women under go an emergency caesarean section during labour, which is not as safe as a planned one.
In the UK doctors are now facing the prospect that they will legally have to inform women of the risks of a vaginal birth after a court ruling over a vaginal birth.
Hans Peter Dietz, an Australian obstetrician who has researched how the risks of a natural birth increase with age told The Daily Mail that women deserve to be ‘treated like adults’ and given unbiased and accurate information.
He conducted a study that found for every year later a woman has her first child, her risk of the pelvic floor muscles tearing increases by 6 percent.
That’s not to say that caesareans are the better choice, they too come with risks. Black points out that scarring from a caesarean makes each future pregnancy more risky as it can affect the development of the placenta. She says there is also some concern that babies born by caesarean could be at higher risk of developing asthma.
Different risks, but really, in the scheme of things low risks just like with vaginal births.
Women confess the thoughts they had while giving birth.. Post continues after video.
Black argues that individual women will value these risks differently so “informing them of the merits of both options would empower them to decide what matters most to them."
“For some that will be the opportunity to experience labour and the benefits of vaginal birth, for others it will be the option of a more controlled and predictable caesarean birth.”
“But in reality,” she writes, “things are more complicated. If potential risks of vaginal birth are routinely discussed with all women, caesarean section rates in UK hospitals are likely to rise further. “
Women need to be informed of the merits of both options to empower them to decide what matters most to them. Image via IStock.
Many women say that pregnancy is stressful enough without having to unnecessarily worry about risks, while it is important to be informed they don’t want another layer of anxiety when they are already be bombarded with information.
But Obstetrician Dr Bryan Beattie says women can’t make the right decision without information, and for each woman the right decision is personal.
He told New Scientist magazine: “They have got leaflets about c-sections, yet most people opt for a vaginal birth and there are no risk leaflets for them.
"You might say to me: ‘I could cope with a wound infection if I had a c-section but I could not cope with faecal incontinence from a bad vaginal delivery.
"You should be allowed to make that choice and you can’t if you don’t have the information."
Top Comments
For me, my order of preferences was (1) non-medicated vaginal delivery (but with option of epidural if needed). (2) elective c-section (3) emergency c-section (4) use of forceps or a train wreck vaginal delivery.
So I wanted (1) and did every thing I could to get there (including walking almost 10km a day, yoga for spinning babies, pain management techniques and maybe a gazillion squats!)...but after 48hours of being mechanically induced at 2 weeks past my due date with zero contractions and cervix and baby still tight and high, I made the informed choice to proceed with an elective c-section rather than with a drug induced labor which meant my risks of emergency c-section or assisted delivery was higher. I feel very lucky that I was so well informed, partly due to my OB and partly due to my wonderful pregnancy group.
You simply can't generalise.
A woman who labours relatively easily will have a completely different birth experience to a woman who has lengthy and complicated labours resulting in painful and invasive procedures to get the baby out.
My sister in law pushed out 3 babies, all over 9 pounds, in under 3 hours each, no pain relief and no stitches required. So her experience or the experiences of women like her as great for them but it's very import to remember that these women are the lucky ones and not the norm.
It's not like that for most women. In fact most of my friends were so traumatised by their first labour experience they all opted for elective c-sections for their next children.
And that's the thing. I know two women who popped their babies out the old-fashioned way in less than two hours. The worst they suffered was "a bit of a headache". Two Panadol and they were wanting to go home.
Every c-sections is surgical and every c-section carries standard surgical risks, both short and long-term.