Expecting Pelvic Health

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Vaginal Birth versus Cesarean

To continue the What They Don't Tell You Series we need to talk about the differences between birth methods so we can understand what happens to our bodies during each.

Most of us know the two ways babies are birthed: vaginal and cesarean.

You may be thinking, "well of course I know the difference" and if you've experienced both then you have a leg up on the rest of us.

However, most of us don't really know the physical differences each has on our body.

Let me help clear that up.

A vaginal delivery is just that, the baby is birthed through a small hole in the pelvic floor, aka the vagina.

A cesarean delivery, the baby is birthed through an incision made in the abdomen and uterus.

Now, let's look a little closer at each.

VAGINAL DELIVERY

A vaginal delivery may be natural with no medical intervention or have medical intervention.

A natural delivery means the woman's body went into labor on it's own, chose or was unable to use medication for pain relief, and did not need any equipment or intervention to remove the baby from the vagina.

Medical interventions during a vaginal delivery may include: induction (which may include membrane sweeping if not consented), pain relief medication, IV, fetal monitoring, forceps, episiotomy, and vacuum.

Without getting extremely technical what our bodies need to be able to do for a vaginal delivery is the following:

  • Open and expand the upper pelvic rim and SI joints
  • Use the power of the uterine contracts to help the baby descend into the vaginal canal
  • Open and expand the lower pelvic rim and coccyx
  • Relax the pelvic floor

This process may be affected by the position of baby, pregnancy complications (preeclampsia, placenta position, etc), pain management, medical interventions, distractions or actions that may slow moms progress.

This is where I can get super detailed about what happens to the body, especially to the pelvic floor, but that is for future posts.

Ultimately, our body will either be able to pass the baby through the vagina or the decision will be made that a cesarean is required.

CESAREAN

There are two ways a cesarean is the birth method... an emergency after pushing is not successful or the life of baby or mom is at risk and a scheduled cesarean.

Before an emergency cesarean the mom's body goes through the same processes as a vaginal delivery and may even have other medical interventions performed prior to the cesarean.  She may even push for hours, which can  affect the pelvic floor almost as much as a vaginal delivery.

For those who have a scheduled cesarean, the mom knows exactly when she will be birthing the baby.  A cesarean is scheduled for many reasons, a few of these are pregnancy complications like placenta privea, baby's position, being "over due" and for some a previous cesarean.

This is what happens to the body during a cesarean:

  • A catheter is placed so you can pee
  • The mom is given a spinal block or epidural to numb the lower half of the body. In some emergency situations general anesthesia is given.
  • Horizontal incisions are made just above the pubic bone - cutting through skin, fat, and fascia.
    • The muscles are not actually cut, however the the fascia that connects them are and then separated to pull the muscles apart.
  • The uterus is then cut and the baby is eased out
  • The uterus is massaged to help the placenta release
  • The incisions are stitched or stapled back up layer by layer
  • Then you are in recovery - where you catheter is eventually removed

 

So what really happens to the body during a cesarean beyond the steps of getting the baby out. Again, this is the topic of another post.... so stay tuned.

To recap...a vaginal delivery requires a full stretch of the pelvic floor to birth the baby & a cesarean is major abdominal surgery.

Regardless of the birth method your body just went through intense changes during pregnancy which affect the structure of the pelvis, spine and soft tissues in the abdomen and pelvis...not to mention other joints like our feet and shoulders. Which means your body has already undergone changes that have nothing to do with birth method and can affect long term health and fitness.

To be continued...