Caesarean vs Vaginal Birth

Everything You Need to Know

Giving birth through a Caesarean section, or C-section, is nothing new — in fact, Pliny the Elder suggested that being born this way is how Julius Caesar got his name.

In South Africa, there is a growing trend toward women having C-sections: according to the 2015/2016 District Health Barometer report, about 26% of babies born in public hospitals are by Caesarean section (C-section). The private sector is no different and in fact shows a higher trend as the Council for Medical Schemes’ annual report reveals about six out of 10 mothers delivered by C-section in 2017.

However, some moms-to-be are willing to deal with the intense pain of labour because they’re either concerned about the potential side effects of pain medication or simply want to follow in the footsteps of women who have given birth naturally for centuries.

If you’re wondering about the advantages and disadvantages of these two birthing methods, Bestmed recommends making an informed decision that suits your medical needs and personal choices best. Here are some of the differences between C-sections and natural birth. 

Elective Caesarean Section

An elective C-section is a major abdominal surgery that may be pre-planned for various medical reasons, such as previous C-section deliveries, high or low blood pressure, heart disease, or diabetes.

The obstetrician makes a small, horizontal incision just above the bikini line. Then, once the uterus is exposed, they make another horizontal incision in the lower half of the uterus. The baby is then pulled out, briefly but thoroughly examined and cleaned up, and swaddled. The entire procedure takes about 45 minutes.

Pros: Cons:
  • Removes the surprise elements of birth such as contractions and labour, as well as arrival date.
  • Quick, painless procedure.
  • No risk of vaginal tearing and your vagina stays intact.
  • Mom will be conscious during the entire procedure.
  • Longer recovery period.
  • Pain when moving around may be a problem after the surgery.
  • A larger risk of post-op infection.
  • Urinary incontinence may be a problem in the future.
  • Blood clots in the legs, pelvic organs or lungs can also occasionally occur.

Emergency Caesarean Section

There is a difference between an unscheduled C-section and an emergency C-section, although people often use the terms interchangeably. Unplanned caesareans are still considered urgent, but typically mother and baby aren’t in life-threatening situations, e.g. labour isn’t progressing or her contractions are too weak. Emergency C-sections occur when serious complications arise during labour and immediate delivery is the only way forward.

The procedure for an emergency C-section is the same as for an elective C-section, however, the obstetrician will try to complete the surgery in under 30 minutes in order to avoid further distress on mother and baby. The pros and cons are also similar to an elective caesarean, with one or two additional factors to consider.

Pros: Cons:
  • Considered safer than vaginal delivery when you have medical complications, e.g. twins, a large baby or a difficult position for labour.


  • There probably won’t be time for an epidural or spinal block, so mom will be unconscious for the birth of the baby.
  • The general anaesthesia may lead to severe headaches, dizziness and nausea after the procedure.

Vaginal Birth

Vaginal birth is the delivery of a baby from the uterus (womb), out through the vagina. This form of birthing is recommended to women who haven’t had any complications during their pregnancy.

Occasionally forceps or a vacuum device are required to assist, and this is known as instrumental delivery. Vaginal birth happens in three stages: Labour, pushing and delivery, and the delivery of the placenta.

Medication in the form of a spinal block or epidural may be used to help with pain.

In general, there are two types of drugs for pain relief: analgesics and anaesthetics. Analgesics lessen pain without loss of feeling or muscle movement. Anaesthetics relieve pain by blocking most feeling, including pain.

Pros: Cons:
  • Recovery time after birth is considerably less.
  • No scar after giving birth.
  • After a vaginal birth, mom is usually able to hold her baby and start nursing sooner after delivery.
  • Society is more prone to give mom a “badge of honour” for giving birth naturally.
  • Pain during labour can be controlled with a spinal block or epidural.
  • If an emergency C-section is required, the epidural dose can easily be increased for the surgery.
  • Increased chance of blood loss.
  • Extremely high blood pressure that can result from the pain response may increase the risk of haemorrhaging.
  • Skin and tissue around the vagina may stretch and tear as the baby moves down through birth canal. If this happens, the tear may need stitches.
  • Mom may have some pain in the perineum —the area between the vagina and the anus.
  • Pain medication may result in itching, nausea, vomiting, feeling drowsy, or having trouble concentrating.

 Natural Birth

Natural birth is the same process as a vaginal birth. However, in this case no medication is used in the birthing process. This could be for religious or medical reasons, or just personal preference.

The pros and cons are similar to a vaginal birth, with one or two additional factors to consider.

Pros: Cons:
  • Without pain relief you can feel your reflexes more enabling you to push more. This can reduce the time you are in labour.
  • Many believe that pain during labour guides the mother into the correct positions for birth.
  • Mom is not attached to an IV or a monitor which makes moving around easier.
  • The mother won’t lose any sensation or alertness during the birth.
  • Many women have a strong sense of empowerment after completing a natural birth.
  • Mothers will feel pain during labour and delivery.


Get Professional Advice

It’s important to get guidance from a qualified health care professional. Choose a provider who makes you feel comfortable and who will work with you to have a healthy pregnancy right from the start.

Bestmed Is With You

With all the pressure of planning your birth, finances are the last thing you need to worry about. As a Bestmed member, you have access to many maternity benefits. Depending on your plan, we’ll give you access to pregnancy consultations, 2D scans, dietician consultations, Biokineticist consultations, supplements and pathology tests to ensure you and baby are as healthy as can be.

Remember to get pre-authorisation from Bestmed before you book your hospital bed for delivery. Call us on 08600 2378 or email us at

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