Our resident GP Dr Zak examines the case for different birthing methods. 

There are two methods of delivering a baby - either vaginal or caesarean section. Currently in the UK, three-quarters of deliveries are vaginal, the remainder a combination of planned sections.

A caesarean section is a surgical procedure carried out by an obstetrician, a specialist in women’s health. It involves a horizontal cut to the abdomen, usually 10-20cm in length, just below the ‘bikini line’. This allows access to the uterus, which is opened to deliver the baby and placenta. Once any bleeding has been addressed, the womb and abdomen are closed back up, and if the baby is well, they can be given to mum for skin-to-skin contact.

The majority of sections are performed under regional anaesthesia, either spinal or epidural or a combination, but in certain situations, general anaesthesia is required.

Reasons for having a section are medical or ‘non-medical’. Potential medical reasons are due to maternal and/or foetal issues, such as uncontrolled infections or a low-lying placenta, among other things. Emergency sections are performed in response to complications during attempted vaginal delivery, such as the mother becoming unwell with issues including raised blood pressure, excessive vaginal bleeding or fatigue, or if baby is struggling.

‘Non-medical’ reasons are often due to anxieties over the actualities of vaginal delivery. The term ‘tokophobia’ means a significant fear of childbirth. Previous negative experience of vaginal delivery will affect a woman’s view, although tokophobia occurs in first-time mothers. It may be a reaction to previous psychological, physical or sexual abuse.

Statistics show that for uncomplicated pregnancies, vaginal delivery is safer than caesarean section. Some consultants do not advocate ‘non-medical’ caesarean sections, but it is a mother’s right to decide her method of delivery, and be referred to a specialist who will facilitate c-section if desired.

Neither vaginal delivery nor c-section is without potential complications. Yet the majority of vaginal births are largely uncomplicated, and the same can be said for caesarean section. Obstetricians and indeed all doctors are trained to adopt a holistic approach to patient care, and you should never be afraid to ask any question, or express any fear.

For more information about caesarean sections, see www.nhs.uk, www.rcog.org.uk or tommys.org.