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Dr. Andrew Rynne

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Pregnant. Will it be safe to go for c-section or vaginal delivery?

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Dr. S Patra

OBGYN

Practicing since :2011

Answered : 4047 Questions

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Posted on Wed, 17 Apr 2013 in Women's Health
Question: I am 32 weeks pregnant and have been reading about vaginal delivery v/s C-Section. Even C-section is very different if it is elective or emergency. I know a lady who has just delivered vaginally and suffered many tears and stitches, and she mentioned that recovery was pretty bad and labour pain was excruciating. She found it hard to sit while feeding her baby. I am unable to decide what is the right way for me. I am not in favor of either yet, but need to decide whether I should ask for an elective C-section to my doc or should just wait and watch. What is your opinion? I do not have a low lying placenta.
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Answered by Dr. S Patra 24 hours later
Hello XXXXXX,

Thanks for posting your health query to XXXXXXX platform. I am trying to give answer as per your concern.

First of all, you should know that a term pregnancy is defined as gestational period in between 37th-40th completed weeks. Decision of mode of delivery for a healthy baby can only be taken when you are in the term.

If there is no such pregnancy related complication or other systemic disorder, you can opt either elective c-section to avoid labor pain/ vaginal tear etc or natural way through vaginal delivery by wait & watch and periodic monitoring of fetal well being.

There are several merits and demerits in both mode of delivery of the baby. Here, I just mention some significant ones as follows:

MERITS OF VAGINAL BIRTH:

1) Here, you need more strength mentally & physically to tolerate labor pain and give vaginal birth. Though, you have quick recovery time with less postpartum pain and shorter hospital stay (1-2 days).
2) Baby have low risk of certain respiratory problems like transient tachypnea, pulmonary HTN, asthma etc.
3) You can start breastfeeding of the baby immediately after birth within half an hour and make a better emotional bonding.
4) There is low risk of maternal hemorrhage or XXXXXXX organ damage and labor event will be shorter in future pregnancy.

DEMERITS OF VAGINAL BIRTH:

1) Most common presentation is fear & anxiety for excruciating labor pain till completion of vaginal delivery.
2) Complications like excessive maternal hemorrhage in some cases, deprivation of oxygen of the baby in case of prolonged labor/ cord compression, perineum and vaginal tear (from mild to fourth degree), prolapse of pelvic organ in future, uterine inversion in rare case etc.
3) In case of episiotomy wound, you may feel pain during sexual intercourse for first 3 months after birth. Tailbone may be injured if you have narrow pelvis.
4) There is higher rate of urinary incontinence in vaginal birth than C-section. It is basically seen in prolonged labor or assisted delivery with instrumentation.

MERITS OF PLANNED C-SECTION:

1) It is more convenient and less stressful mode of delivery in most of the women. When you are near term, you can consult with your doctor to opt planned C-section and you will be scheduled for that. You can also avoid post-term pregnancy and related complication by it.
2) There is low risk for maternal hemorrhage or uterine atonicity (most common cause of PPH) in comparison to emergency C-section and vaginal delivery.
3) It has reduced risk of XXXXXXX organ damage, birth canal trauma, baby injury, pelvic floor injury, urinary incontinence or anesthesia related problems than emergency C-section.

DEMERITS OF PLANNED C-SECTION:

1) C-section is always a major abdominal surgery and there is certain risks and complication. It may be anesthesia related or surgical procedure related. Moderate to severe headache, nausea, vomiting, low back pain are quite common features in postpartum period.
2) It has longer recovery period and you have to stay longer period in hospital in comparison to vaginal delivery.
3) Some complications like wound hematoma, uterine rupture in case of having previous C-section, excessive hemorrhage during procedure and may need to undergo hysterectomy, postpartum infection, venous thrombosis, risk of injury to bladder or bowel during surgery, mild nicking to baby by scalpel (in some cases only), decreased bowel function for first few months, increased risk of developing certain respiratory problem for baby etc.
4) Breastfeeding is most difficult after C-section and can be initiated only after 4 hrs or later. Lastly, it is more expensive than vaginal delivery and you must check your insurance policy.

In addition, pelvic assessment & monitoring of fetal well being are necessary by your consulting obstetrician before proceeding to vaginal delivery. In case of contracted or narrow pelvis, C-section is superior to all above.

I have discussed all things (merits & demerits) in relation to both mode of delivery. You need to consult with your obstetrician to make a decision for the right choice near term after complete assessment.

For any future query, you can directly ask me by viewing this page WWW.WWWW.WW
Wish your good health & successful motherhood.

Regards,
Dr Soumen

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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