Risks For The Mom

Unlike vaginal birth, a c-section is major surgery, and that means recovery and the risk of complications. Fortunately, the risk of losing the mother to surgical complications has declined dramatically over the past century, and two recent studies have revealed that women who undergo scheduled cesareans are now even less at risk than women who deliver vaginally.

But excessive bleeding, infection, and injury to such abdominal organs as the uterus, intestines, and bladder can occur. Women who've had a c-section are slightly more likely than those who've given birth vaginally to need readmission to the hospital, most commonly for uterine infection or bleeding. Again, most complications occur in unplanned cesareans performed after a woman's water breaks and labor begins.

Then there's recovery, which can take weeks. "I couldn't get out of bed without hurting," says Ferguson. "So I let my husband do everything. I didn't even change my son's diaper for two weeks, not until my husband had to go back to work." After this experience, she wanted a vaginal birth with her second pregnancy. Because of the risks of "vaginal birth after cesarean," or VBAC, she couldn't find a hospital or birthing center willing to perform one. Eventually, she found a midwife to deliver her second child at home, an experience she describes as "awesome." After ten hours of active labor, Ferguson delivered 8-pound, 12-ounce Liam: "I was walking around the house the second day and nursing without problems."

Benefits For The Mom

For many women, the most important long-term benefit is the protection of the pelvic floor  -- the muscles that support the uterus, bladder, and other abdominal organs. When the baby's head passes through the birth canal, it can damage the nerves and muscles there. The risk increases if the doctor has to use forceps.

This can lead to postpartum incontinence, uncontrollable urination that often occurs when you run, cough, or even laugh. Fortunately, it usually goes away in a few months.

For a minority of women, though, incontinence keeps returning. For more, vaginal delivery contributes to a gradual, age-related weakening of the pelvic floor, which increases the chances of incontinence in later life.

Women who have a c-section not only avoid postpartum incontinence but also have a lower risk of it when they're older: Those who've delivered only by cesarean have at least half the rate of moderate to severe incontinence as women who've given birth vaginally. Another medical advantage: If your cesarean is planned, you won't need to have it in an emergency situation  -- which is far more likely to cause injury, or worse.

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