Experts state that vaginal delivery is always the first choice as long as conditions are suitable and there is no risk for the mother and baby, but they also point out that many complications can arise during vaginal birth. Prof. Dr. Arif Aktuğ Ertekin stated that the belief of 'vaginal delivery at all costs' has been abandoned today, and safe delivery for both mother and baby has come to the forefront. Ertekin pointed out that in situations where the baby cannot progress through the birth canal, vital risks can arise for both mother and baby, adding, “According to current knowledge, the mode of delivery has no additional benefits or risks for the baby’s general health, except in extraordinary circumstances.”
Üsküdar Üniversitesi Faculty of Health Sciences Dean Prof. Dr. Arif Aktuğ Ertekin explained the difference between vaginal delivery and Cesarean section.
In difficult births, the mother's uterus may need to be removed to save her life
Prof. Dr. Arif Aktuğ Ertekin stated that in vaginal delivery, the baby passes through the vaginal canal with the natural contractions of the uterus, separating from the mother's body and being born, and he described Cesarean section as follows:
“In Cesarean section, a skin incision is made in the abdominal area, and the layers of the anterior abdominal wall are opened sequentially. Upon reaching the abdominal cavity, an incision is made in the uterus, and the baby is delivered from the abdomen by a doctor. After the baby is born, all cut abdominal layers are sewn and closed in accordance with anatomy and procedure, and the Cesarean delivery is completed.”
Prof. Dr. Arif Aktuğ Ertekin, addressing which delivery option might pose risks for the mother and baby in different situations, explained these risks as follows:
“Babies with excessive weight may get stuck while passing through the birth canal during vaginal delivery, and their heartbeats may become irregular. In such cases, an emergency Cesarean section may be necessary, and if not intervened in time, the baby may even die. In situations like shoulder dystocia where the shoulder area gets stuck in the birth canal, a fractured clavicle or loss of arm function due to damage to neck and arm nerves, and brain damage (cerebral palsy) due to insufficient oxygen supply to the brain, can occur.”
Ertekin, noting that some risk factors can also emerge in the mother if the baby cannot progress through the birth canal, said, “Uterine rupture due to very strong uterine contractions in the birth canal or external genital area, or bleeding occurring after birth, can be observed. In such situations, if intervention is delayed, the mother may lose her life. Sometimes, in cases of unstoppable bleeding with medication or interventions, even if the mother is young, her uterus may need to be removed to save her life. In such circumstances, opting for a Cesarean section is the correct approach.”
Situations preventing the baby from progressing through the birth canal can pose vital risks
Prof. Dr. Arif Aktuğ Ertekin pointed out that in cases where the baby enters the birth canal with its breech (known as breech birth) or lies sideways in the mother's womb (called transverse lie), uterine rupture in the mother and severe injuries, even death, can occur in the baby. He stated that in such situations, a Cesarean section should be chosen instead of vaginal delivery.
“Myomas in the mother that block the birth canal can prevent the baby from progressing through the birth canal, thereby hindering vaginal delivery or causing severe postpartum hemorrhage,” said Ertekin. He noted that in such cases, whether delivery is vaginal or by Cesarean section, bleeding and clot distribution to other parts of the body might still occur afterward. Ertekin added that since blood would not flow past the vessels blocked by the clot, that area would not be nourished, cells would die, and related problems, even death, could result.
Viral diseases in the external genital area can be transmitted to the baby via vaginal delivery
Prof. Dr. Arif Aktuğ Ertekin pointed out that there is a risk of infection in pregnancies where the water sac ruptures prematurely, stating, “If an infection develops and the baby is delivered vaginally or by Cesarean section, serious infections can occur in both the mother and the baby. In this situation, Cesarean delivery is not preferred, but it can be performed out of necessity to save the baby's life.”
Ertekin stated that there is a risk of viral diseases in the external genital area, such as herpes and condyloma, being transmitted to the baby via vaginal delivery and causing severe infection, adding, “In individuals with blood clotting disorders or those with a history of vascular clotting disease, there is a risk of both bleeding and recurrence of the disease after both types of delivery.”
Delivery method has no additional benefits or risks
Prof. Dr. Arif Aktuğ Ertekin stated that the belief of 'vaginal delivery at all costs' has been abandoned today, and safe delivery for both mother and baby has come to the forefront. Ertekin said, “According to current knowledge, the mode of delivery has no additional benefits or risks for the baby’s general health, except in extraordinary circumstances.”
Vaginal delivery is possible for mothers whose first birth was a Cesarean section
Prof. Dr. Arif Aktuğ Ertekin also addressed whether mothers whose first birth was a Cesarean section could have a vaginal delivery, stating, “If sufficient time has passed since the Cesarean section (usually 2 years) and there have been no subsequent problems, if an emergency situation such as uterine rupture or fetal heart rate irregularities develops in patients, if there is an opportunity to perform a Cesarean section within minutes, and if the patient accepts vaginal delivery after being informed of the potential risks, then vaginal birth after Cesarean (VBAC) can be attempted and is possible.”
Ertekin concluded his remarks as follows:
“As long as conditions are suitable and there is no risk for the mother and baby, vaginal delivery is always the first choice. Thus, reducing the risk of uterine rupture in subsequent pregnancies, the need for repeat Cesarean sections, and associated surgical risks are primary goals.”