Benefits of Vaginal Birth

Rates of physiological or 'natural' vaginal birth are very low in Australia (Li et al. 2012). As a result, research which compares caesarean birth with vaginal birth is on the whole comparing caesarean birth with 'medicalised' vaginal birth. This makes it very difficult to provide good information about the benefits of 'natural' vaginal birth. Vaginal birth leads to a fast recovery period for the mother and a greater likelihood of breastfeeding success. It boost the baby's body systems making transition to the world smoother. Labour hormones serve to enhance the experience of mother and baby when they first meet, supporting bonding. Vaginal birth supports the baby's longer-term growth, health and development compared with caesarean birth.

It is hard to compare the risks of vaginal birth with the risks of caesarean, as the number of women who give birth 'naturally' in Australia is very low, and so there is very little data. To demonstrate, the most complete data we have for how women went giving birth is for 2010. In 2010, labour started on its own for 27% of women e.g. labour was not induced. Of these women, 25% did not use drugs for pain relief. A very basic way of working out how many births were 'natural' is to say that it was 25% of all the labours which started on their own (Li et al. 2012). This means that just under 7% of births did not involve any medical intervention and were therefore 'natural'. Studies which compare vaginal birth and caesarean birth are not comparing 'natural' or physiological birth, they are comparing statistics from all vaginal births, the vast majority of which are 'medicalised'.

Physiological vaginal birth has positive short- and long-term health benefits for the mother and the baby.

Benefits of physiological birth for the mother include:

• being more likely to breastfeed successfully (RCOG et al.2012, Mercer 2001);
• a shorter physical and psychological recovery period after the birth (RCOG et al. 2012);
  
• an opportunity for personal growth from a deep sense of achievement and emotional wellbeing (Callister et al.2003, Niven and Murphy-Black 2000, Thomson and Downe 2010);
• a cocktail of labour hormones which enhance mother–baby attachment and support early breastfeeding success (Lagercrantz et al.1986; Tronick et al. 2009, Carter et al. 2008, Odent 2013).

Benefits of physiological birth for the baby include:

• boosting the baby's body systems to cope with the change from womb to world including: blood sugar regulation, breathing (Lagercrantz et al.1986); temperature regulation (Mostyn, Pearce et al. 2004); blood circulation to the baby's brain (Grattan et al. 2008, Hyde et al. 2012); exploratory behaviours (Matthiesen et al.2001);
• providing a cocktail of labour hormones which enhance mother–baby attachment and support early breastfeeding success (Lagercrantz et al.1986; Carter et al. 2008 Tronick et al. 2009; Odent 2013);
• enhancing the baby's longer-term growth, health and development compared with caesarean birth (MacKay et al. 2010; Hyde et al. 2012; Cardwell et al. 2008; Huy et al. 2012);

Hypothetical benefits

• exposing the baby's body inside and out, to friendly bacteria before other bacteria can take a hold (van Nimwegen et al. 2011; Huy et al. 2012);
• switching the newborn baby's genes on in a way which optimises the baby's brain development (Dahlen et al. 2013)

References

• Callister, L., Khalaf, I., Semenic, S. et al. (2003) The pain of childbirth: perceptions of culturally diverse women. Pain Management Nursing,k 4(4): 145-54.
• Cardwell, C.R. et al. (2008). Caesarean section is asso-ciated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia. May 2008, Volume 51, Issue 5, pp 726-735.
• Carter, C.S., Grippo, A.J., Pournajafi-Nazarloo, H., Ruscio, M.G., Porges, S.W. (2006). Oxytocin, vasopressin and sociality. Prog Brain Res. 2008; 170:331-6.
• Dahlen, H.G., Kenned, H.P., Anderson, C.S., Bell, A.F., Clark, A., Foureur, M., Ohm, J.E., Shearman, A.M., Taylor, J.Y., Wright, M.L., and Downe, S. (2013). The EPIIC hypothesis: Intrapartum effects on the neonatal epigenome and consequent health outcomes. Med Hypotheses. 2013 May; 80(5): 656-662. Available online at http://ww.ncbi.mlm.nih.gov/pmc/articles/PMC3612361/
• Grattan, D. R., and Kokay, I.C. (2008). Prolactin: A Pleiotropic Neuroendocrine Hormone. DOI: 10.1111/j.1365-2826.2008.01736.x
• Huy, S.Y., Rifas-Shiman, S.L., Zera, C.A., et al. (2012) Delivery by caesarean section and risk of obesity in preschool age children: a prospective cohort study. Arch Dis Child. 2012 Jul;97(7):610-6. Epub 2012 May 23.
• Hyde, M.J., Mostyn, A., Modi, N., Kemp, P.R.(2012). The health implications of birth by Caesarean section. Biol Rev Camb Philos Soc. 2012 Feb;87(1):229-43.
• Lagercrantz, H., Slotkin, T.A., (1986). The ‘stress of being born. Sci Am. 1986; 254:100-7.
• Matthiesen, A.S., Ransjo-Arvidson, A.B., Nissen, E., Uvnas-Mober, K., (2001). Postpartum maternal oxytocin release by newborns: Effects of infant hand massage and sucking. Birth. 2001;28(1):13-19.
• MacKay DF, Smith GC, Dobbie R, Pell JP. (2010). Ges-tational age at delivery and special educational need: retrospective cohort study of 407,503 schoolchildren. PLoS Med. 2010 Jun 8;7(6):e1000289.
• Mercer, J. (2011). Current best evidence: a review of the literature on umbilical cord clamping. Journal of Midwifery and Women’s Health, 46(6): 402-14.
• Mostyn, A., Pearce, S., Stephenson, T. and Symonds, M.E. (2004). Hormonal and nutritional regulation of adipose tissue mitochondrial development and function in the newborn. Experimental and Clinical Endo-crinology and Diabetes, 112(1), 2-9.
• Van Nimwegen, F.A., Penders, J., Stobberingh, E.E., et al. (2011) Mode and place of delivery, gastrointestinal microbiota, and their influence on asthma and atopy. J Allergy Clin Immunol. 2011 Nov;128(5):948-55.et-3. Epub 2011 Aug 27.
• Niven, C. and Murphy-Black, T. (2000) Memory for labour pain: a review of the literature. Birth, 27(4): 254-5.
• Royal College of Obstetricians, Royal College of Mid-wives and National Childbirth Trust (2012). Making sense of commissioning Maternity Services in Eng-land. Available online at http://www.rcm.org.uk/college/policy-practice/government-policy/commissi... [Accessed on 20 February 2013]
• Thomson, G.M. and Downe, S (2010). Changing the future to change the past: women’s experiences of a positive birth following a traumatic birth experience. Journal of Reproductive and Infant Psychology. Pages 102-112, Volume 28, Issue 1, 2010. DOI:10.1080/02646830903295000.
• Tronick E, Reck C. (2009). Infants of depressed mothers. Harv Rev Psychiatry. 2009;17:147–56.