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Having your first baby is THE most amazing experience. If it is a planned pregnancy and both partners are happy about it, you will have much to plan and celebrate.
You may have already researched and decided with your doctor, the best type of birth for you. VB vs C-section. If you have not, we have just fleshed out below what the 2 methods involve you frame your discussion with your doctor. Always choose a doctor who is easy to talk to and will spend time with you as there are lots of choices to be made and the doctor can help you make them.

Vaginal Birth
A vaginal birth is often considered a “natural” birth (which is a bit supercilious as it’s not as if C sections aren’t natural). Basically, closer to your due date either your water will break, or you will start to have contractions – at which point you need to head to the hospital.
At the hospital you will be monitored and when your cervix is fully dilated (10 cm) it is time to start the pushing process. You will work with your contractions to push the baby out of the womb and into the birth canal. When the baby crowns, a final push will enable to baby to emerge fully. Contractions will continue so that your body can get rid of your placenta.
Recovery is usually very quick after a VB, and you will be able to go home with the baby after about 24 hours depending on your doctor. You will continue to experience mild cramping, vaginal bleeding, and perineal soreness for about 4-6 weeks as your body recovers from the stress of childbirth.

Things to think about with a VB
- It is possible that your perineum may tear or be at the risk of tearing during labour and your doctor may perform an episiotomy. This will require stitches and the scar often takes a few weeks to heal. You should have this discussion with your doctor before the delivery and you can opt NOT to have an episiotomy unless necessary.
- After a vaginal birth, many women experience lack of bladder control
- You may also suffer from organ prolapse where the pelvic floor muscles get weak and more pliable due to a hormone surge during birth and the pelvis suffers a prolapse.
- If you are concerned about pain during a vaginal birth, DO discuss pain medications with your doctor beforehand- there are many options like pethidine / epidurals and your doctor will be in the best position to advise you on the pros and cons of these. DON’T be afraid to ask about additional costs if this is a factor that concerns you.
- Vaginal deliveries are generally not covered by insurance in Sri Lanka - DO check this out if this is a concern.

 C-section
A Caesarean or C-section is an alternative to vaginal birth. It can be an elected C-section where the doctor / patient opts for a C-section which allows a planned birth, etc. Or it can be something that the doctor recommends either beforehand or during delivery due to complications with the pregnancy / birth itself.
A C-section is considered a surgery - which may involve an epidural or general anesthesia. It involves an incision across your abdomen and uterus so that the doctor can extract your baby. Like any surgery it has the potential to get complicated, but it is fairly routine now and doctors are very experienced. However you will need help after you get home with the baby so enlist support from family members.
Recovery takes a lot longer than with a Vaginal birth. It may take a few days before you can leave the hospital with your baby, and it will take 4-6 weeks after birth for your body to recover fully. You may be required to be careful during that time to ensure that your stitches/ wound don’t get infected or open up.

Things to think about with a C-section
- For your next delivery, you may be asked to go for a C section again, although this is also changing now. The reason for this is the danger of your scar opening which poses a danger to both mother and baby. In 2010 the National Institute of Health in the US started encouraging vaginal births after a C-section and now VBACs are becoming more common even in Sri Lanka. Discuss this with your doctor beforehand so you know what is possible and what isn’t.
- Even after a C section you will go through the normal process of vaginal bleeding and cramping etc. as your body recovers
- However, the risk of urinary incontinence is much lower as is the risk of a pelvic organ prolapse
- C-sections are covered by health insurance in Sri Lanka

 

Research resources:

https://www.healthline.com/health/pregnancy/c-section-vs-natural-birth-2#risks-and-complications
https://www.pvhmc.org/blog/2018/july/once-a-c-section-always-a-c-section-/
https://www.parkwayeast.com.sg/healthplus/article/natural-delivery-caesarean-delivery


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