Deciding between a natural birth or planned c-section: Pros & cons?

@ lesliefu

Is it Dr Richard Ooi? He did my epidural when i delivered last year. The discomfort and pain was minimum. He is very patient and make me feel comfortable with it.

@ charade

You're right with the epidural thing. I didnt feel ashame of taking the epidural becoz i had back pain for more than 12 hours and i kind of know i wont be able to push effectively let alone have to deal with more pain. Before they give me my 2nd dose of epidural, i felt pain in between and i'm so glad that i had epidural.

After my delivery, in less that 12 hours, i was "up and running" doing breastfeeding in the hospital. Yes, i've got some stiches, but i think i can deal with the pain more than those labour pain.
 
I wish I had known how to go about insisting on the epidural in the public system. it's the one thing that would make me go private. OK and also the awful doctor who said to me "please, the pain isn't even that much" when i was in the throes of labour. Luckily I didn't see her after that and the midwives did the actual delivery and were awesome.

@lesliefu one thing about the public system is that you don't have a choice about c-sec. They will decide if it's medically necessary (and I think they're quite good about making that decision if needed) and I was completely confident that I would not be pushed into a c-sec otherwise.
 
I've posted a lot of things on this topic in the past two months. I am pregnant with my second child. My first child was born completely naturally without pain medications and I was in labor for 43 hours and also hemorrhaged afterward.

If I had it to do over again (the same birth), although because of experience I would have done some things differently, I would always choose a natural, unmedicated birth. I believe that is what I owe myself and my child.

I can tell you that I was fully conscious and aware during the birth of my son and that it was a profound and changing moment in my life. It was the most empowering event in my life so far and as my midwife told me afterward, "Now, you can do anything." I truly can do anything after that experience. There is a TON of information out there about the facts about what childbirth is. I encourage you not to give into the media hype (all the shows on TV like: A Baby Story, I Didn't Know I Was Pregnant, Deliver Me, One Born Every Minute as well as films like Knocked up etc.). We all know that "if it bleeds, it leads" (newspaper term) and every producer needs to get drama up there on the screen to get ratings. Hollywood is not reality.

Here is just a sampling of the things I've posted here on this site within the last 2-3 months (some older), including studies, statistics, documentaries, illustrated guides and videos. Do your own research and don't let fear stand in your way--fear is the number one enemy of birth--in order to embrace birth and have a good experience you have to not be crippled by fear--no matter how many horror stories you hear (and people sure like to tell them, right?)--the problem is you're not hearing the empowering, miracle stories that are out there (and there are plenty--you can find many samples below).

So, check out the resources below and :flower:be inspired:flower:--birth is a beautiful thing and it is not just about babies being born--mothers are also born when they give birth. Women are strong. You are strong and your body is capable of giving birth well--don't let anyone or anything convince you otherwise.

As far as the HK hospital system goes when it comes to birth--I can understand how you feel overwhelmed. I am not a huge fan of how things are done here in HK and with my first pregnancy I was so overwhelmed by everything that I chose to return to my home country to give birth.

This time, I'm older and wiser and I'm giving the HK system a go--but on my terms--which means I've had to plan very well this time. I am optimistic that anything is possible with the right preparation and resources. You can always PM me if you want more info.

Finally, CONGRATULATIONS on your pregnancy!


Resources


If You're Going To Give Birth, Watch This (link to full online documentary for: The Business of Being Born)

Orgasmic Birth (20/20 video)
Orgasmic Birth (article)
Great Resource for Pregnant Ladies (videos by "Mother of Modern Midwifery" Ina May Gaskin)
Let Your Birth Experience Be Inspired (wonderful compilation of real-life birth experiences--videos)
Free Downloadable Healthy Birth Guide by Choices in Childbirth
Benefits of Vaginal Birth for Mother and Baby
Reducing Infant Mortality
Unnecesarean and ICAN (great website resources)
Birth Brain Injury: Etiology and Prevention
7 Signs of a Bad Doctor (selecting a doctor)
The Win-Win Birth Plan
Nice Printable Guide for Labor Positions
Pregnancy Blogs Worth Checking Out
Outlaw Births
Male Doctor Experiences Childbirth Pain
 
NicoleJoy totally agree about the episiotomy- I had one with my first birth as it was a forceps delivery with epidural and it took quite a while to heal. Second with 2nd degree tear I didn't even feel when it happened (no drugs) and it healed really quickly. Also agree with your comments about c sections, especially as you say you can have an epidural if the pain gets too much.
Thanka2 was waiting for your post on this as I know you have posted some great links on this recently, especially the Business of Being Born; I really hope RileyC watches it as it is so spot on.
 
NicoleJoy totally agree about the episiotomy- I had one with my first birth as it was a forceps delivery with epidural and it took quite a while to heal. Second with 2nd degree tear I didn't even feel when it happened (no drugs) and it healed really quickly. Also agree with your comments about c sections, especially as you say you can have an epidural if the pain gets too much.
Thanka2 was waiting for your post on this as I know you have posted some great links on this recently, especially the Business of Being Born; I really hope RileyC watches it as it is so spot on.

Yes, the Business of Being Born is a fantastic documentary. I watched it once by myself and once with my husband. I also have ordered all of Ina May Gaskin's books (from ShopinHK.com) and can't wait to read what she's written. So inspiring.

Regarding episiotomies. In the 12-week birth course my husband I took the instructor gave a simple demonstration: She folded a piece of paper in half and then asked one of us to rip it along the folded line. The paper ripped quite easily. Then she gave us an unfolded piece of paper and asked us to tear it from top to bottom--of course it was possible to tear it but ti definitely didn't tear as fast as the folded piece of paper. So it is with episiotomies. If your perinium is going to tear, it's going to tear but the likelihood that it will tear further and deeper increases with the help of a scalpel to start the process. If you want to avoid perinial tears (most midwives working in home settings NEVER see perinial l tears or perform episiotomies) there are some things you can do including:

1. Don't wear underwear. I know, I know, sounds all risque and stuff but it's not. We all have to wear panties at some point but don't wear them when you don't have to (to sleep in, around the house when you don't have guests etc.) Wearing underwear traps unnecessary moisture and can cause your skin to become brittle and somewhat chapped. There is a great example from the book "Husband-Coached Childbirth" where the doctor is the OBGYN for a woman who lives in a nudist colony and he said she had one of the healthiest perinial areas because it was constantly exposed to "the elements."

2. Do your Kiegel exercises faithfully
--it strengthens the pelvic floor and makes the perineum stronger and more flexible.

3. Perform perineal massage with a natural oil (olive oil) from at least week 36 onward for at least 5 minutes every day.

4. Use warm compresses on the perinium throughout labor as well as oil massage to prepare the area for the "big stretch" (thanks, Baby Mama).

5. Don't lay back during labor. In other words, do not let your practitioner or anyone else force you into the Lithotomy Position and this is why. Your chance of both tearing or having an episiotomy goes up substantially in this position. Alternatively, get into the most vertical position possible (squat, kneel, stand, sit)--it opens up everything "down there" and helps to prevent tearing.
 
Last edited:
If you don't want to tear....

NicoleJoy totally agree about the episiotomy- I had one with my first birth as it was a forceps delivery with epidural and it took quite a while to heal. Second with 2nd degree tear I didn't even feel when it happened (no drugs) and it healed really quickly. Also agree with your comments about c sections, especially as you say you can have an epidural if the pain gets too much.
Thanka2 was waiting for your post on this as I know you have posted some great links on this recently, especially the Business of Being Born; I really hope RileyC watches it as it is so spot on.

Yes, the Business of Being Born is a fantastic documentary. I watched it once by myself and once with my husband. I also have ordered all of Ina May Gaskin's books (from ShopinHK.com) and can't wait to read what she's written. So inspiring.

Regarding episiotomies. In the 12-week birth course my husband I took the instructor gave a simple demonstration: She folded a piece of paper in half and then asked one of us to rip it along the folded line. The paper ripped quite easily. Then she gave us an unfolded piece of paper and asked us to tear it from top to bottom--of course it was possible to tear it but ti definitely didn't tear as fast as the folded piece of paper. So it is with episiotomies. If your perinium is going to tear, it's going to tear but the likelihood that it will tear further and deeper increases with the help of a scalpel to start the process. If you want to avoid perinial tears (most midwives working in home settings NEVER see perinial l tears or perform episiotomies) there are some things you can do including:

1. Don't wear underwear. I know, I know, sounds all risque and stuff but it's not. We all have to wear panties at some point but don't wear them when you don't have to (to sleep in, around the house when you don't have guests etc.) Wearing underwear traps unnecessary moisture and can cause your skin to become brittle and somewhat chapped. There is a great example from the book "Husband-Coached Childbirth" where the doctor is the OBGYN for a woman who lives in a nudist colony and he said she had one of the healthiest perinial areas because it was constantly exposed to "the elements."


2. Do your Kiegel exercises faithfully
--it strengthens the pelvic floor and makes the perineum stronger and more flexible.

3. Perform perineal massage with a natural oil (olive oil) from at least week 36 onward for at least 5 minutes every day.

4. Use warm compresses on the perinium throughout labor as well as oil massage to prepare the area for the "big stretch" (thanks, Baby Mama).

5. Don't lay back during labor. In other words, do not let your practitioner or anyone else force you into the Lithotomy Position and this is why. Your chance of both tearing or having an episiotomy goes up substantially in this position. Alternatively, get into the most vertical position possible (squat, kneel, stand, sit)--it opens up everything "down there" and helps to prevent tearing.

Just a bit of a quote of why this position (which is what the hospitals in HK favor) is such a BAD idea all around (however, it is convenient for your doctor because he/she can sit there comfortably and not have to be inconvenienced much)

Roberto Caldeyro-Barcia, past president of the International Federation of Obstetricians and Gynecologists, states unequivocally, "Except for being hanged by the feet, the supine position is the worst conceivable position for labor and delivery" (1975:11). There are a number of problems generated by this position: (1) it focuses most of the woman's body weight squarely on her tailbone, forcing it forward and thereby narrowing the pelvic outlet, which both increases the length of labor and makes delivery more difficult (Balaskas and Balaskas 1983:8); (2) it compresses major blood vessels, interfering with circulation and decreasing blood pressure, which in turn lowers oxygen supply to the fetus (for example, several studies have reported that in the majority of women delivering in the lithotomy position, there was a 91% decrease in fetal transcutaneous oxygen saturation (Humphrey et al. 1973, 1974; Johnstone et al. 1987; Kurz et al. 1982); (3) contractions tend to be weaker, less frequent, and more irregular in this position, and pushing is harder to do because increased force is needed to work against gravity (Hugo 1977), making forceps extraction more likely and increasing the potential for physical injury to the baby; (4) placing the legs wide apart in stirrups can result in venous thrombosis or nerve compression from the pressure of the leg supports, while increasing both the need for episiotomy and the likelihood of tears because of excessive stretching of the perineal tissue and tension on the pelvic floor (McKay and Mahan 1984).
 
Last edited:
I wish I had known how to go about insisting on the epidural in the public system. it's the one thing that would make me go private. OK and also the awful doctor who said to me "please, the pain isn't even that much" when i was in the throes of labour. Luckily I didn't see her after that and the midwives did the actual delivery and were awesome.

With my second, I just insisted. Even when they needed to do vacuum delivery, I wouldn't let them do an episiotomy. They cannot do it without your consent (unless it is a true emergency, and even then I'm not sure about what they can do legally if you have insisted on no episiotomy) - so all you need to do is to make it clear that you do not want it and their hands are tied. They cannot do it without your consent.

With my first, I didn't really care either way - they told me it would make her come a bit quicker and at that stage, I was thinking ANYTHING to make her come quicker! (they had turned off the epidural for that stage of labour and I was having really bad back labour due to her being face up instead of face down). If I could change anything about my labour, it would be the choice to have an episiotomy.

With my second, I bargained a lot more with the midwives. They said "We think you should do this" and I said "No, how about this instead". Knowledge is power and being the second time around, I was a lot more prepared and knew what WAS important and was NOT important to me. You are the boss, even in the public hospitals!
 
Agreed, being induced makes way worse contractions. I had 3 on top of each other, for more than 5 min total. Not fun. That one, emerg c-section, couldn't hold baby for 6 hours, but no problem bonding. This one, planned c-section(in public), and bonded immediately. I was ecstatic the moment she was lifted from me, my little angel. She got to breastfeed within 45 minutes. It was love at first sight.
Any way birth happens is painful and downright barbaric. But we recover, and are the better for it.
 
Experiences vary so much, it really is difficult to effectively use other people's experience other than to vaguely inform your own decision. Over the course of your pregnancy, you will likely have a feeling of what is right for you. Just go with it.

As for me, I had two natural deliveries (both at Matilda with same OB). For the first, I had an epidural and one top up. With the top up, my contractions slowed down so much that they actually had to give me pictosin (sp?) to kick start labor again and ensure that I didn't have an emergency c. The contractions were pretty darn painful after that and I wondered how much more painful a drug free delivery would have been. For #2, I decided to go without the epidural for as long as I could and ended up with a faster (slightly more painful, but MUCH faster, drug-free delivery). Another poster above had two top ups with no problem (same hospital as me), so you never know.

I have friends who had planned c-sections (not for medical reasons) and don't feel like they missed out on anything. For me, having had the natural experience and later seeing their heads pushing through and their little face popping out (yes, we have video), was pretty amazing. For what it's worth, a friend who had one of each found her recovery from a c-section not to be a big deal at all.

Another poster mentioned people exaggerating. I think that part of the issue is that until you experience it, you can't really appreciate what they are talking about. 10-20 hours of labor sounds unbearable, but it's not. The intensity of labor can be all over the map. From the first contraction until delivery, I was actually "in labor" longer with my second but the period of intense pain and pushing was much shorter. @15 hours of with the first and @20 with the second but during that period, I went out to lunch!
 
Agreed, being induced makes way worse contractions. I had 3 on top of each other, for more than 5 min total. Not fun. That one, emerg c-section, couldn't hold baby for 6 hours, but no problem bonding. This one, planned c-section(in public), and bonded immediately. I was ecstatic the moment she was lifted from me, my little angel. She got to breastfeed within 45 minutes. It was love at first sight.
Any way birth happens is painful and downright barbaric. But we recover, and are the better for it.

This cartoon illustration from The Business of Being Born (starting at 1:18) sums up the pitocin-->epidural-->c-section cycle very well. Many a normal labor becomes an emergency c-section labor thanks to the introduction of pitocin. Plus, if you're doing pitocin, it overrides your body's natural pain killer, oxytocin which means you have to have an epidural because your body stops pumping out oxytocin to deal with the pain.

Not that it's any surprise to SZJ but I totally cannot agree that "any way birth happens is painful and downright barbaric"--I think that's the thinking we've all be indoctrinated with and that's what we expect but there are plenty testimonies to the contrary. Besides, pain is a part of being alive--as one lady on the above mentioned documentary said, "When I gave birth, that was the day that I felt most alive."

When I was in university I boarded with a family who did home birth (at the time they were doing their first home birth, now they have 5 children, all born at home) and I remember talking with my roommates about "Do you think we'll hear screaming and all that when she's in labor?" Come to find out, she was so relaxed in labor and her particular way of going through the pain was to internalize instead of vocalize--it wasn't that bad. It can be barbaric--but that just depends on the situation--especially the environment.

Having said that, if you think it's going to be a nice day out walking in the park (whether you do c-section, natural birth, pain killers to the hilt or whatever) you're in for a surprise--you're going to have to go through something to come out on the other side. Anything worth having is worth going through something for.
 
i took the remark regarding exaggerating rather personally. i had two terrrible pregnancies and one terrible birth... for someone to say that i was exaggerating (i realise she might not be talking about me personally) i find offensive. it diminishes what i went through, the pain i felt, and the emotions that i had to deal with.

women should stand up for each other, not tear each other down.

some women have uneventful pregnancies and deliveries. i think they are extremely lucky and i would NEVER imply that they are exaggerating how "good" their experiences were. but not everyone is so lucky.

again, the intention of my post was NOT to tell a war story, it was merely to point out that c-sections are MAJOR surgery and the decision to have one should not be taken lightly.
 
i took the remark regarding exaggerating rather personally. i had two terrrible pregnancies and one terrible birth... for someone to say that i was exaggerating (i realise she might not be talking about me personally) i find offensive. it diminishes what i went through, the pain i felt, and the emotions that i had to deal with.

women should stand up for each other, not tear each other down.

some women have uneventful pregnancies and deliveries. i think they are extremely lucky and i would NEVER imply that they are exaggerating how "good" their experiences were. but not everyone is so lucky.

again, the intention of my post was NOT to tell a war story, it was merely to point out that c-sections are MAJOR surgery and the decision to have one should not be taken lightly.

Hey carang,

I didn't read the above posts so I'm not sure about what exactly was mentioned. But, when I read the comment about how women exaggerate, I tend to think that in general, birth is made out to be this catastrophic event in and of itself. We see it in the movies. We watch it on TV. The Womens Magazines focus on it. It's everywhere. The message is: The Act of Childbirth is Gonna Getcha'!

Now, you know me and I know you and we both had our share of hell to go through in childbirth (I tend to think you went through more than I did but again, I'm not comparing scorecards here). But, the truth is, that doesn't mean birth in itself is a messed-up biological function. Sure, both of us had messed-up experiences in some way--our bodies had weaknesses and difficulties that were particular to our situations and our health backgrounds. I mean, I was predisposed to bleed too much--it runs in my family--it's a health condition. There are ways that our bodies kind of pooped out on us and we did our best to deal with those situations and well, we must have done okay because we're both here right now. :)

But, the truth--the actual truth is that most pregnancies and births are normal. Less than 10% of all pregnancies in the developed world are actually high-risk cases. So, most women can look forward to a healthy birth. That doesn't mean that all women on this forum are going to be able to have one but the majority will. And the majority of the women here do not medically need interventions to go through labor--I'm talking about medically indicated interventions--not elective interventions. Our bodies are fabulous and they are designed to work but many doctors will try to convince you otherwise--that your body is faulty and is going to fail you--how depressing is that? And the stress of it all becomes a self-fulfilling prophecy.

I was just thinking about this this afternoon. I haven't actually had a chance to ask my own doctor these two questions but I will pose them to him next week when I see him.

1. Have you ever personally attended a unmedicated, natural childbirth?

2. What is your personal intervention rate? If you are the attending doctor at 10 womens' births, how many of those do you suppose will end up having interventions? How many of those are mother-directed interventions and how many are interventions you directly chose? (forceps, vaccuum, induction, augmentation, epidurals and c-sections)?

I am very curious to find out.

Anyway, I think it is important for us all to tell our birth stories even if they happen to not be the most pleasant experiences--they all matter.

I just try to be careful to not do what a woman at my mother's church in the States did when I was about 30-some weeks pregnant. She walked up to me and out of the blue said, "Not to scare you, but so-and-so went into labor and gave birth to a stillborn and she was at the same point in pregnancy as you are now." I just looked at her and said, "I'm sorry, but I just don't accept those words you just spoke to me" and I made it a point to avoid her from then on. What was the point of her telling me that horrible story? Nothing. It's totally different when you tell your story to inform others.
 
thanka, i agree with you. birth is a natural thing. women have been doing it since "the beginning". i was like any other woman before i gave birth. i had my concerns about both "versions". ended up, i didn't have a choice. i could have had a stroke or a heart attack if i'd tried it naturally.

if truth be told, i am a little jealous of women who are able to enjoy their pregnancy and have a "natural" birth. it was not something that was ever in the cards for me... even if i were to have another baby, i would not be able to have a vaginal birth....

i didn't post my initial post to scare the OP, rather to inform her. i purposely did NOT put in any of the gory details of my first delivery or of either of my terrible pregnancies. (if she wants those, it's not hard to search this forum for them). again, my intention was only to inform.

but for someone to say that bad birth experiences are exaggerated belittles you and me and anyone else who had a difficult delivery.

i would NEVER, EVER, EVER walk up to anyone getting ready to deliver and offer my "war story". that is cruel and unusual punishment and should be treated as such. but when one comes on here LOOKING for stories... that's a different story.
 
@taysty - yes, it's Dr Richard Ooi, he was great!

@charade - good to know about the c-sections at public hospitals! :) i have a lot of faith in the public system here.

as for episiotomy - though i know i never had one, i know for a fact that if i had one for my first pregnancy that my daughter would have been born 1.5hrs earlier and she wouldn't have ended up with meconium aspiration. don't know if there was a problem with my doctor (whom I've obviously never used again!) but my 2nd doctor believes that it would have definitely speeded things up and helped the baby come out faster...so, it was "medically" necessary - but like many people, i took a class and they said to us NEVER to get one, so when the doctor asked me, of course I said no - right off the bat...should have had more questions for him, but it was the 1st, so we were inexperienced. anyhow, it doesn't sound fun, but if i could go back, i would definitely have one...you see, my daughters head was "bigger" than "normal"...still is - she's a big head girl! just my 2 cents..
 
Hi everyone! Sorry for not responding earlier- I wanted to make sure that I read everyone's posts carefully to honour the time that you all spent in sharing your individual experiences. It was very enlightening, so a BIG thank you to all! I certainly learnt a lot more from reading your posts here than from researching the Net and speaking to my doctor. For example, I had no idea that inducement is likely to increase the strength of the contractions. Overall I'd say that I'm feeling a lot more confident about going the natural route and I think the epidural is the way to go!

carang: I find your direct, honest, and warts-and-all account of your birthing experiences most refreshing! It definitely sounds as though you had a hard time and I don't think that you're exagerrating. After all, I came on here to understand more about the pros and cons of natural vs C-sections!

To banane76 and thanka2: I will definitely get my hands on the "Business of being born" and look into the other resources mentioned by thanka2. Thx

To the ladies who had an episiotomy, I feel for you! My mother also had an episiotomy and I know from her that it's extremely painful. I hope to avoid it at all costs, so thanka2's tips will be borne in mind.
 
to riley (also the name of my #2),

i truly wish you an uneventful pregnancy, the birth that you want, and a wonderful & healthy child !
 
you recover a lot sooner if you have a natural birth. also you can bear many more children having natural birth when compared to c-section. my fd was told after 3 kids she shouldn't have anymore, which was said because she had three boys and she really wanted one more girl!
 
I'm a newcomer, and a bit late for this discussion, but I just wanted to thank everyone for their extremely informative and interesting comments.

Also, I wanted to add that one thing to bear in mind when contemplating this choice (if it is a choice for you) is that many doctors and hospitals do not allow VBACS, as the risk of vaginal rupture is higher with a VBAC. However, studies have shown that multiple C-sections are just as dangerous or more so than VBACs. Many women are told they cannot have vaginal births after they agree to a cesarean, but after a few of those, are told they are simply not allowed to bear children at all (a la jojoye's comment above) because the risk of serious internal damage is so great with multiple surgeries. For most modern families, this is not an issue, as we typically don't have big families anyway these days. But if you don't want to be told you CANT have more children, you need to go natural, and save the C section for your last one, if you ever decide to have an elective one at all.
 
Back
Top