Childbirth is a defining moment in every woman's life., It never leaves you the same way it found you, writes Njoki Chege

Childbirth comes with added responsibilities to a woman. Suddenly, your priorities change and you too are bound to change.

But what we sometimes overlook is the impact of the method we choose to use as we give life. While others opt for the caesarean section method, where the baby is delivered through surgery, others prefer the tried and tested ‘old-fashioned’ delivery.

There are reasons behind the options for child delivery, but one question remains, ‘which is which?’

Natural birth or vaginal birth is the oldest and commonest mode of delivery. It goes without saying that whenever the topic of natural childbirth is brought up, we immediately think of pain, kicking and screaming.

This could probably be the most basic definition of natural delivery! However, natural childbirth is defined as the mode of delivery that attempts to minimise the intervention of modern medicine, including surgery.

The baby exits the mother’s body through the birth canal, a process that is aided through pushing and adequate breathing on the side of the mother. In the last month of pregnancy, the cervix softens and ripens like a fruit. Contractions of the uterus become noticeable, and the baby settles into the pelvis. The cervix stretches and opens, and the baby moves lower and rotates, eventually moving down the birth canal. With each contraction, pain sends a signal to the brain and oxytocin is released. The contractions then increase in intensity. As the pain increases, more oxytocin is released and the contractions become harder. The pain of labour and pushing hard is what most women worry about. It is important to understand that the pain of the contractions is valuable. It is an important way in which nature helps women find their ways of facilitating birth. In real sense, the pain of each contraction is a guide for the labouring woman.

The positions and activities she chooses in response to what she feels help labour progress by increasing the strength and efficiency of the contractions and encouraging the baby to move down the birth canal.

This mode of delivery is widely believed by physicians worldwide to be the safest and most convenient mode of delivery for mother and child.

According to Child Birth Connections, US, an organisation that helps women and doctors make maternal decisions, natural delivery is advisable because the mother and the child are at a lower risk of infection and complications associated with delivery.

Experts of the same school of thought defend this argument saying that natural delivery is safe because the anaesthetics increase the possibility of complications due to the fact that the woman may not be capable of pushing properly during the final stages of delivery.

In essence, natural childbirth often promotes an overall healthier delivery because it eliminates the risks associated with caesarean sections and possible side effects from certain medications. It is also noteworthy that the recovery period is faster compared to that of c-section, and the mother does not retain any wounds that may take long to heal.

Caesarean section

However, some women will not always deliver through natural means, for varied reasons, hence the c-section method, a surgery that takes no more than 30 minutes. An initial incision and a 5-10 minute wading through the layers of tissue till the baby is found kicks off the surgery. As the doctor reaches the uterus, the amniotic fluid is suctioned away to make room in the uterus for the doctor’s hands to reach for the baby. The baby’s head is usually engaged to the pelvis, and the doctor’s disengages it. The moment is characterised by pressure and nausea for the mother.

The repair of the uterus and the layers cut during surgery then follows suit, and a long healing process follows. While the doctors may advise women to go through c-section as an emergency measure, many women today opt for it, even when it is not an emergency situation.

According to Dr John Ong’ech, head of obstetrics and gynaecology at the Kenyatta National Hospital, "most women who go through a c-section by choice are career women. They do this for fear of labour pains."

He also says that due to the inevitable relaxations of the birth canal muscles as a result of natural birth, women opt for c-section to keep the canal intact and consequently their sex lives.

"They want to maintain the ‘tightness’ of the birth canal, and in the event where a woman has to undergo a natural birth, some go for a reconstruction surgery," he adds.

Ong’ech, however, advises that there is no need to go through a c-section to keep the vaginal muscles intact. He says doctors conduct a procedure known as episiotomy, which involves slitting the birth canal, by a few inches to facilitate birth and later sewing it up, making it even better than it was before childbirth.

Not completely ruling out c-section, Ong’ech says that there are cases where c-sections are absolutely necessary. Indications for a c-section could be when the baby’s cord is around its neck, when the baby is bigger than its outlet and in case of heart ailment. Sarah Kanana Mwebia, 41, delivered her first three children vaginally, but delivered her fourth child through c-section.

"Circumstances forced me to deliver via c-section. After the third child, I developed a heart problem and doctors told me I should either go through a vacuum delivery; where the baby is sucked out of my womb or a c-section."

Two weeks

She opted for the latter.

"It is still very painful. My wound is almost two weeks now but I am a long way from complete recovery," says Sarah, who cannot carry out strenuous activities for the next one month.

On the other hand, Mary Nyaga, 33, just gave birth (on the morning of this interview). She has had two normal deliveries, and has no regrets.

"I believe nobody likes being under the knife, if you have the strength to push, then push the way God intended, unless of course you have a medical case," Mary says.

She refutes claims that vaginal muscles relax and become flabby after normal childbirth, agreeing to the fact that episiotomy does the trick.

"It feels great to give birth normally because even if your energy is depleted, it soon comes back. Look, I gave birth this morning and I am being discharged tomorrow," she continues.

However, c-section, has become a norm among women who may not have serious health complications, and some hospitals have taken this seriously. Some do not allow c-sections unless it is for an emergency purpose.

Compared with vaginal birth, c-section increases a woman’s risk for a number of physical problems. These range from less common but potentially life-threatening problems, including haemorrhage, blood clots and bowel obstruction, to much more common concerns like longer-lasting pain and infection.

Pelvic pain

Even after recovery from surgery, scarring and adhesion tissue increase risk for ongoing pelvic pain and for twisted bowel. A woman also ends up being hospitalised for longer than a woman who has given birth the normal way, resulting to over-dependence on relatives and others around her.

Whichever, way you choose to use while giving life, it is of supreme importance that you consider your medical condition to justify your chosen method of childbirth. As Dr Ong’ech advises that women should stop listening to their friends’ encounters on childbirth, as most accounts are exaggerated anyway. Myths and falsehoods concerning childbirth should not be considered while making this crucial decision of either going under the knife or the normal way.