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What ARE the Risks of Vaginal Birth?

To give equal time in the Risks-Of department, I ask my follow-up question to “What ARE the risks of Cesareans?” – so, what are the risks of having a vaginal birth? In the natural birth arena, much attention is paid to the risks of cesareans… and rightly so… but in the effort of fairness and truth, vaginal births are not without risk, either. Contrary to the saying, “Birth is as safe as life gets,” I’m of the school that believes there are a lot less risky things in life than having a baby. We’re nearly immune to the realities of the inherent dangers in childbirth anymore, by virtue of where we live… with back-up doctors, anti-hemorrhagic medications, antibiotics, clean operating rooms and plenty of skilled physicians and nurses to attend to us. But, looking around the world, a “simple” vaginal birth is an event that brings terror to women and their families. Even with my beliefs and no matter how hard I try to understand, the concept of one woman in 14 dying is unfathomable. The United States’ risk of dying in childbirth is one in 2100.

I asked the question in Facebook and here are the answers, including great answers from nurses who are on the front lines of both types of births. My asides in italics. 

K: Defining risk as being exposure to the chance of injury or loss, I would say, there is a chance you may have a tear down there, if you are not prepped for birth, that is.

S: You can have a tear down there even if you are 'prepped for birth'.

K: Vaginal tearing, shoulder dystocia, hemorrhoids.

S: There are risks of nerve and tissue damage during/from the second stage, blood pressure-related concerns, risk of pelvic/tailbone damage, tearing, bleeding, infection... among others, but those risks are rather rare.

K: Bleeding and infection are risks of any birth, not specific to vaginal delivery.

S: True, but having a vaginal birth still poses those risks. The question was about the risks of vaginal birth, not about risks EXCLUSIVE to vaginal birth.

K: True, I guess I should have said your perineum being prepped... though it is still a risk either way.

NgM: I am quite confused about what a “perineum being prepped” is.

S: Having a baby to take care of afterwards. (admittedly, not exclusive to vaginal birth)

NgM: I found it interesting that women injected comments of the positives of vaginal birth. Not surprised at all, however.

R: Brachial plexus birth injury, incontinence,  permanent nerve damage to clitoris, Pelvic Floor Dysfunction...

C: A really ugly lady garden after.

C: I’ve got to say though, having experienced both routes, it’s vaginal all the way for me.

K: You are at great risk of giving birth the way nature intended.

Childbirth is not without risks, but the evidence points to vaginal birth as the shortest recovery time, fewest complications, and best for both mom and baby. C-sections save lives, but are far from an uncomplicated alternative.

NgM: Another interesting interjection.

C: Urinary and anal incontinence. Painful vaginal area. Loss of vaginal tone (worked with a doc that would use that as his leading cesarean argument).

S: I think we'd have to define risks involved with vaginal delivery at home vs. vaginal delivery at the hospital as well.

You'd also have to look at these risks based upon statistics and how often they occur and then also each individual and their history.

My maternal side's birthing history is an excellent one. German genes and extremely easy birthing experiences. My "risks" are lessened in that aspect. Someone with different genes and a familial history of difficult births will then probably inherit some of those difficulties associated with their birthing history as well. Smaller pelvises/frames will have a tad more difficulties than larger pelvises/frames will.

General risks are cord prolapse, placental previa, nuchal limb presentation that could cause deep tissue tears, and perineal tearing as well. These are not hereditary.

Abnormal Uteri can cause complications. Then looking at PCOS, cysts, and more - they can all increase "risks", as well.

Birth, no matter how you slice it, is a risk. It doesn't matter if you birth vaginally or surgically. Death, infection, complications come from both choices.

Being educated about your body, about birth, and about possible signs of complications will put you ahead of most. Knowing and understanding your family history and what YOU are comfortable in dealing with during birth (epidurals, IV's, interventions of any kind) will help YOU have control of the birth.

As natural as birth is, so is death and even complications. Try not to worry, as it can be harmful to the baby. Just be educated though.

E: I think incontinence was a risk with either route? It seems like I've read that its pregnancy rather than birth that causes it. Ditto hemorrhoids, certain pelvic organ prolapses....

K: Well, I had a accreta with my third child and have never had a CS. I did not realize that was a risk in someone without a C/S history but have since learned differently (the really hard way.)

A: Shoulder dystocia!

J: Pelvic organ prolapse, tears.

J: I have had one mom from my classes who stretched her pelvic ligaments so far after birth that she was not able to walk for a few days after. Six months after her baby's birth she is still doing special exercises.

NgM: Thanks to all the women who participated... are we missing anything?