Another frequent question asked by our pregnant mothers is: Which is better – caesarean section or vaginal delivery?
The argument is complex. Very complex. Many issues need to be considered.
Among these issues:
1. Some patients will need a caesarean section – a ‘transverse lie’ is a good example. Certainly trying a ‘version’ i.e attempting to get the ‘transverse’ lie into a ‘cephalic’ (head down) lie is possible but fraught with risks.
2. The risks to the mother are much higher with caesarean delivery but the risks to baby are perhaps less.
3.Nobody can tell for sure if vaginal delivery will indeed eventually be possible. Without trying, you will not know.
4. If an attempt to deliver vaginally fails, an emergency caesarean will be required. The risks associated with an emergency caesarean are far greater than an elective caesarean. The risks of elective caesarean section are greater than vaginal delivery. Hence an attempt at the ‘safest’ option may inadvertently lead to the ‘least safest’ option instead!
5. Other issues need to be considered. If the mother needs to be induced (example: poor fetal growth, diabetic pregnancy at term etc, etc), the chances of achieving a vaginal delivery drop dramatically.
6. Logistics – sometimes the mother requires a multi-disciplinary support mechanism to be in place during the time of delivery. An example would be severe heart disease complicating the pregnancy. This may be difficult to achieve if the delivery occurs at 4am!