An empowering birth is all about informed consent and making your own best choices.  Let’s discuss the natural childbirth dangers and the risks that you should know.

(Unmedicated) Natural Childbirth Dangers:  Prolonged Time To Receive Anesthesia

The main danger of a natural, or unmedicated, childbirth is the time it takes to receive anesthesia if an emergency arises.  For example, if mom is in the pushing phase and baby develops significant distress, an emergency cesarean might be indicated.  If mom does not already have an epidural on board, there may be additional delay to start the cesarean.  Aside from that risk, an unmedicated childbirth is generally regarded as the safest way to experience a vaginal birth.  Sure, there are other natural birth pros and cons…but no other notable dangers.

With that said, most women who want to learn more about natural childbirth dangers are really wondering about the dangers of a vaginal birth.  These terms are often confused.  (For a more detailed definition, check out our blog post, “What is Natural Childbirth.”)

Natural childbirth is a birth without the use of pain medication.

A vaginal birth is when the baby is born through the birth canal.  This stands in contrast to a cesarean birth, where baby is born via a surgical incision made directly into the uterus.

Vaginal birth offers an array of amazing benefits for you and your baby.  But like any choice in healthcare, it comes with its benefits AND its risks.

(Vaginal) Natural Childbirth Dangers #1:  Perineal Injury

The perineum is the area between the vagina and anus. It stretches and thins out as baby’s head descends through the birth canal.

When compared to a cesarean birth, vaginal birth increases mom’s risk of injury to the vagina and perineum.  The pressure of the baby’s head as mom pushes can result in a tear to the skin or muscles around the vagina, known as a perineal tear. Perineal tears are common and can occur in up to 85% of first-time moms after a vaginal birth (1).  Most are small and don’t require stitches.

On the other hand, severe perineal tears (3rd and 4th degree), can have long-term consequences such as fecal incontinence, fecal urgency, and chronic perineal pain (2).  The incidence of severe tears ranges from 5-10% of all women who give birth vaginally (2).

There is a very strong connection between forceps delivery and perineal trauma.  (Read “Assisted Delivery vs C Section” to learn more about forceps delivery, also known as an operative or assisted delivery.)  Women who have an assisted or operative vaginal birth are 3.5 times more likely to experience severe perineal tears than women give birth without forceps (3).

(Vaginal) Natural Childbirth Dangers #2:  Pelvic Floor Injuries

The pelvic floor is a group of muscles that work like a sling to supports mom’s internal organs (ie. bladder, uterus, bowel), as well as the weight of the baby.  Strong pelvic floor muscles lead to improved bladder and bowel control and reduce a woman’s risk of pelvic organ prolapse (3).

The weight of the baby during pregnancy can passively stress and weaken the pelvic floor muscles regardless of the way you give birth.  However, vaginal birth makes pelvic floor injury even more likely.  During birth, the head passes through the muscles of the pelvic floor.  Weak muscles combined with a prolonged pushing phase–most especially when forceps or a vacuum device are used–can create trauma to the pelvic floor.  Symptoms such as stress urinary incontinence and pelvic organ prolapse may result (5,6).

NOTE:  I am a HUGE advocate for pelvic floor physical therapy.  I encourage all women to visit a pelvic floor physical therapist before and/or during their pregnancy to learn how to strengthen their muscles for the work of supporting the weight of the baby during pregnancy.  Additionally, I encourage all women to see a pelvic floor physical therapist after birth to learn how to recondition the muscles of their pelvic floor.  

(Vaginal) Natural Childbirth Dangers #3:  Cephalopelvic Disproportion

In the process of vaginal birth, baby must work his way down through the passage of mom’s bony pelvis.  The inlets and outlets of the pelvis have different dimensions, and there are multiple bony protuberances along the way.  Baby must twist and turn his head to navigate through.

If mom has a narrowed diameter in the pelvic inlet or outlet and baby is larger than the pelvic diameters, it can result in cephalopelvic disproportion (CPD).  In other words, baby doesn’t fit.  To accommodate, baby may move into abnormal positions and presentations.  Unfortunately, this can lead to prolonged labors, an inability of the baby to descend, and even uterine rupture (7).

Despite the risk, it’s important to note that true CPD is rare, occurring in 1 out of 250 pregnancies (8).  Simple techniques such as repositioning mom into a sitting, squatting, or hands-and-knees position can increase the pelvic outlet diameters.  But at times, a cesarean birth may be necessary.

Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!

References:

(1) Feigenberg, T., Maor-Sagie, E., & Zivi, E. (2014).  Using Adhesive Glue to Repair First Degree Perineal Tears: A Prospective Randomized Controlled Trial.  BioMed Research International, Article ID 526590, 5 pages, 2014. doi:10.1155/2014/526590

(2)Priddis, H., Schmied, V., & Dahlen, H. (2014). Women’s experiences following severe perineal trauma: a qualitative study. BMC Women’s Health, 14, 32. http://doi.org/10.1186/1472-6874-14-32

(3) Smith, L. A., Price, N., Simonite, V., & Burns, E. E. (2013). Incidence of and risk factors for perineal trauma: a prospective observational study. BMC Pregnancy and Childbirth, 13, 59. http://doi.org/10.1186/1471-2393-13-59

(4) De Silva, K.-L., Tsai, P.-J. S., Kon, L. M., Hiraoka, M., Kessel, B., Seto, T., & Kaneshiro, B. (2014). Third and Fourth Degree Perineal Injury After Vaginal Delivery: Does Race Make a Difference? Hawai’i Journal of Medicine & Public Health, 73(3), 80–83.

(5) Memon, H., & Handa, V. L. (2012). Pelvic floor disorders following vaginal or cesarean delivery. Current Opinion in Obstetrics & Gynecology, 24(5), 349–354. http://doi.org/10.1097/GCO.0b013e328357628b

(6) Handa, V. L., Blomquist, J. L., Knoepp, L. R., Hoskey, K. A., McDermott, K. C., & Muñoz, A. (2011). Pelvic Floor Disorders 5-10 Years After Vaginal or Cesarean Childbirth. Obstetrics and Gynecology, 118(4), 777–784. http://doi.org/10.1097/AOG.0b013e3182267f2f

(7) Ladewig, P.W., London, M., Davidson, M. (2006).  Contemporary maternal-newborn nursing care.  Pearson Prentice Hall.  Upper Saddle River, NJ.  p. 525.

(8) American Pregnancy Association.  (2015).  Cephalopelvic Disproportion (CPD).  Retrieved from http://americanpregnancy.org/labor-and-birth/cephalopelvic-disproportion/.