What problems are more common with vaginal birth as compared to C-section (but have not been sorted out for women giving birth after previous cesarean)?

C-section offers advantages in a few areas, primarily with some aspects of the recovery period after birth. Some practices used with vaginal birth, such as episiotomy, are associated with pelvic floor problems, but it’s wrong to conclude that vaginal birth itself causes such problems (research is needed to better understand the role of care practices in pelvic floor outcomes) (see the section Preventing Pelvic Floor Dysfunction for more information on this issue).

  • A woman who has a vaginal birth is more likely to:
    • Have a painful vaginal area in the weeks after birth
    • Leak urine with stress, such as vigorous exercise, short-term after birth (urinary stress incontinence)Press, J.Z., Klein, M.C., Kaczorowski, J., Liston, R.M., von Dadelszen, P. (2007). Does cesarean section reduce postpartum urinary incontinence? A systematic review. Birth, 34(3), 228-237.
  • Babies born vaginally have been shown to be at higher risk for a nerve injury affecting the shoulder, arm or hand (brachial plexus injury). It is usually temporary

A systematic review has found that having a cesarean versus vaginal birth does not protect against having uncontrolled loss of feces or gas (anal incontinence).Nelson, R.L., Furner, S.E., Westercamp, M., & Farquhar, C. (2010). Cesarean delivery for the prevention of anal incontinence. Cochrane Database of Systematic Reviews, (2):CD006756.

A systematic review has found that having a cesarean versus vaginal birth does not protect against severe urinary stress incontinence and any urinary urge incontinence (difficulty waiting to urinate).Press, J.Z., Klein, M.C., Kaczorowski, J., Liston, R.M., von Dadelszen, P. (2007). Does cesarean section reduce postpartum urinary incontinence? A systematic review. Birth, 34(3), 228-237.

Maternal problems that only happen with vaginal birth. The following would not occur with cesarean birth:

  • Injury to the vulva or vagina, with possible pain and infection (genital trauma)
  • A tear or intentional cut (episiotomy) from the opening of the vagina toward the anus, with possible pain and infection (perineal trauma)