Vaginal childbirth, in which the new baby emerges through the uterus and vaginal opening, has been the most common method of childbirth for millennia. But Caesarean sections - delivery by creating an opening through the abdominal wall - has been used for centuries, too. But no matter how long each practice has been used, every new mother will wrestle with the same issues, both physical and emotional.
There are many factors involved in making the difficult decision between vaginal and Caesarean delivery.
The level of pain experienced isn't simply a matter of being 'tough' or committed to 'natural' childbirth. It can have an effect on the baby's well-being, too. Being in labor for hours on end, enduring painful contractions, carries risks. Stress produces hormones that the baby is exposed to, along with the mother. Contractions can produce harmful effects on the child and mother. Rectal tearing, in which the mother tears rectal tissue from straining, is a potential problem.
Vaginal childbirth carries other risks. Breech birth, wrapped umbilical cords and other conditions - while relatively less common - do occur. Breech, in which the baby's butt is toward the vaginal opening rather than its head, isn't the only other possible position. Intermediate positions happen as well. Tangled umbilical cords can strangle the newborn or cut off oxygen. Forceps deliveries and other techniques are sometimes required in such cases.
In some cases, the baby's head may be so large as to produce vaginal tearing, which extends recovery time. Or it may become lodged in the opening for extended periods, presenting a risk to the baby's life and the mother's well-being. Drugs may be needed to induce vaginal relaxation.
Cutting through the abdominal wall, along with the pelvic muscles and uterus constitutes major surgery. Though the procedure is less painful than vaginal birth, the recovery can be extended, especially since anesthesia is required in this case. A (usually subtle) scar is always produced, which some women may find unattractive or undesirable.
Any drugs used during delivery are taken up by the baby, since it shares fluid with the mother until after birth. Anesthesia, in rare cases, has caused neurological problems for newborns. These can be long lasting.
Almost all deliveries - both vaginal and Caesarean - occur without incident, producing a healthy child. There are rarely long-term negative impacts on mother or baby. But knowing the pros and cons of both methods can help expectant women make an informed choice.