Babies can come into this world in one of two ways: vaginal delivery or surgical delivery by caesarean section. The ultimate goal of both methods is to ensure that the baby and mother are healthy.
In some cases, a caesarean section can be expected and thus planned in advance – for example in the case of twins or other multiples; a medical condition such as diabetes or high blood pressure; an infection that can be passed to the baby during birth, such as HIV or genital herpes; or problems with the placenta.
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A caesarean section may also be necessary if the baby is very large and the mother has a small pelvis, or if the baby is not in the head-down position and attempts to turn the baby into this position before delivery have been unsuccessful.
Sometimes the doctor decides to perform an emergency cesarean section because the health of the mother, the baby, or both is at risk. This can happen because of a problem during pregnancy or after a woman has gone into labour, such as if labor is too slow or if the baby is not getting enough oxygen.
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Some C-sections are considered elective, meaning they are required before birth. Some may choose to have a C-section to plan when the child is due, or if they have previously had a complicated vaginal birth. If one qualifies for a vaginal birth, however, there aren’t many advantages to having a C-section.
Although C-sections are generally considered safe and in some situations life-saving, they carry risks. This is a major operation and involves opening the abdomen and removing the baby from the uterus. Because a first C-section often leads to a C-section in future pregnancies, vaginal delivery is usually the preferred method of delivery for a first pregnancy. In Bulgaria, however, more than half of the babies in 2022 were born by C-section, according to the latest statistics. It is considered medically justified for this to occur in up to 15% of births.
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Vaginal delivery in women who have previously had a cesarean section, whether elective or emergency, may be contraindicated depending on the location of their cesarean section and the risk of uterine rupture, where the uterus opens along the old incision. This type of birth is known as vaginal birth after caesarean section (VBAC).
Regardless of how they give birth, women should be as informed as possible about their birth options so they can have a voice in the process, advocate for what they want, and make the most informed choices. Here’s more on the pros and cons of both birth methods.
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Vaginal birth: PROS
Vaginal births usually require a shorter hospital stay and recovery time than a C-section. The typical length of hospital stay after a vaginal birth is 3 to 5 days.
Vaginal births generally avoid the risks associated with major surgery, such as heavy bleeding, scarring, infections, reactions to anesthesia, and longer-lasting pain. And since no major surgery is needed, the mother can start breastfeeding earlier.
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A baby who is born vaginally will be able to have earlier contact with his mother, who may start breastfeeding earlier than she could if she had a caesarean section.
During a vaginal birth, the muscles involved in the process are more likely to push fluid into the newborn’s lungs, which is beneficial because it reduces the risk of babies suffering from breathing problems during birth.
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Vaginal birth: CONS
The passage of the fetus through the birth canal is a long process that can be physically exhausting. On average, first-time moms spend between four and eight hours in active labor, when their cervix is fully dilated and their body wants to push. If the woman gives birth without anesthesia, the contractions, which have the function of pushing the fetus down, are extremely painful and tiring. Many women want anesthesia once labor begins, but an epidural is only given at 3 to 4 centimeters of dilation. After that it is contraindicated.
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During a vaginal birth, there is a risk that the skin and tissues around the vagina will stretch and tear as the fetus moves through the birth canal. Severe stretching and tearing may require stitches. This stretching and tearing can also cause weakness or injury to the pelvic floor muscles that control urinary and bowel functions. At a doctor’s discretion, an episiotomy, which is a controlled dilation of the vagina by cutting, may be necessary. Often, the recovery after such manipulation is long and painful, since the groin is a particularly sensitive area. It is not uncommon for the coccyx to be bruised or cracked during the straining and descent of the fetus, which leads to pain and discomfort for a long time after the birth process.
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A 2018 study in the journal PLoS Medicine found that women who gave birth vaginally were more likely to experience urinary incontinence (leaking urine when they cough, sneeze or laugh) and to have pelvic organ prolapse, meaning one or more organs slip into the pelvis. pelvis, compared to women who gave birth by caesarean section.
Vaginal birth can cause persistent pain in the perineum, the area between the vagina and the anus.
The military “Spartan” transported a pregnant woman in serious condition from Silistra to Sofia
If a woman has had a prolonged labor or if the baby is large, the baby can be injured during the vaginal delivery process itself, resulting in a bruised scalp or a fractured collarbone.
C-section: PROS
A woman may choose a C-section if she has tremendous anxiety about a vaginal birth that may affect her birth experience.
Women who give birth by C-section are less likely to suffer from urinary incontinence and pelvic organ prolapse than women who give birth vaginally.
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A surgical birth can be planned in advance, making it more comfortable and predictable than a vaginal birth.
If the baby or mother is in danger, a C-section can be life-saving.
C-section: CONS
C-sections usually require a longer hospital stay, four to six days on average. The recovery period is also longer and there may be more pain and discomfort in the abdomen as the skin and nerves around the surgical scar need time to heal, often at least two months.
The mother and her baby died in the hospital in Velingrad
A cesarean section increases the risk of complications after birth, such as pain or infection at the incision site.
Caesarean section involves an increased risk of blood loss, as the bowel or bladder may be injured during the operation or a blood clot may form.
Women who had a cesarean section were less likely to initiate early breastfeeding than women who had a natural birth.
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Women are three times more likely to die during a C-section than during a vaginal birth, mostly due to blood clots, infections and complications from anesthesia.
There may also be a greater risk in subsequent pregnancies of future pregnancy complications, such as placental abnormalities and uterine rupture, which occurs when the uterus tears along the scar line from a previous C-section. The risk of placental problems continues to increase with each cesarean section a woman undergoes.
The relatives of the deceased woman in labor met with Dr. Ivanov and part of the team that led the operation
According to a 2019 study published in the journal Allergy, Asthma & Clinical Immunologybabies born by C-section may have breathing problems at birth and even in childhood, such as asthma.
A 2018 study published in the journal PLoS Medicinefound that there was a higher risk of stillbirth when women chose cesarean section.
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During a caesarean section, there is a small risk of the baby being injured by the scalpel during the operation and being injured in general. Some studies, including a 2020 study of more than 33,000 women, suggest a link between babies born by cesarean section and a greater risk of obesity and developing type 2 diabetes as children and as adults.
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