Is a C-Section Easier Than a Vaginal Delivery?

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Mandy Armitage, MD

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Mandy Armitage, MD, is a physician, freelance medical writer, and consultant. For many years, she has combined her interests in clinical medicine with her passion for medical education. She covers a broad range of clinical topics and writes for many audiences, from patients and their families to healthcare professionals. She has several years of experience bringing complex clinical information to the public to help empower them to make decisions about their health.

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What is a C-section and why is it done? 

C-section is another name for cesarean delivery. This is when a baby is delivered surgically, rather than through the vagina. The surgeon makes incisions (cuts) in the abdominal wall and uterus, and then uses their hands to pull the baby out through these cuts. 

Fun fact: Although it’s often said that a cesarean is so called because Julius Caesar was born in this way, no one really knows the real reason behind its name.

In 2011, approximately one in three births in the U.S. happened via cesarean delivery.

When and why is a C-section done?

There are several reasons for performing a cesarean delivery. It may be necessary if problems arise during labor. A C-section performed for this reason is called an emergent cesarean. Sometimes, a cesarean delivery is elective, meaning it is planned and scheduled. This happens either when the pregnant parent chooses to deliver in this way, or when the obstetrician thinks it will be necessary for the parent’s or the baby’s safety. In short, a cesarean delivery can save the life of the baby, the parent, or both.

Here are some examples of situations that call for a cesarean delivery:

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Maternal issues:

• Infection (HIV, herpes)

• Medical problems (high blood pressure)

• Problems with how or where the placenta is attached

Baby issues:

• Large size (can’t fit through the pelvis)

• In the womb, the baby faces feet down instead of head down

• Multiples (twins, triplets)

Labor problems:

• Concern for the baby’s well-being

• Labor is taking too long

• Cervix isn’t opening enough

The complete answer 

The bottom line is that recoveries following vaginal and cesarean deliveries are very different. Each type of delivery also has different risks. We’ll get into those differences here. But remember: Each situation is different, and things can change quickly during childbirth. If you have specific questions or concerns, it’s important to speak with your obstetrician about your wishes earlier rather than later. 

An estimated 2.5% of cesarean deliveries are requested by the pregnant parent.

Is a C-section easier than a vaginal delivery?

There is a misconception that a cesarean delivery is easier than a vaginal delivery. This is not true for a couple of reasons. 

First, if a C-section is scheduled, you don’t go through labor. Some people fear the pain of labor or have anxiety about a long labor, so it might be appealing to avoid it. While this may sound “easy,” the recovery from a C-section is not. It’s longer and made more difficult by the surgical incision.

Second, if a C-section is emergent, it can be scary to experience. For example, the doctor may decide to do a C-section because the baby is not doing well in labor. Also, emergent C-sections are higher risk than elective C-sections.

Is a C-section safer?

Because cesarean delivery is a surgery, it is not risk-free. That said, the risks are different from those of a vaginal delivery. There are situations in which a C-section is a safer option — for the pregnant parent or for the baby, and sometimes both. 

The most common reasons for an emergent C-section are when labor stops progressing and when fetal monitoring leads to concern for the baby’s health. In these situations, a labor could go on for hours before the decision is made to perform a C-section.

A planned (elective) C-section can be a helpful way to avoid labor, which can be risky for some people — for example, if the pregnancy is complicated by high blood pressure. Additionally, a C-section is the safest way to deliver if the placenta is too low in the uterus and covers the cervix. This is called placenta previa. In this situation, a vaginal delivery would be too dangerous. 

As far as the baby is concerned, a C-section helps to avoid some risks associated with the baby going through the vaginal canal. These can include problems with the umbilical cord, the baby not getting enough oxygen during the delivery, or the baby breathing in fecal material (called meconium aspiration).

Sometimes, the position of the baby calls for cesarean delivery, for example, if its head is not pointing down in the uterus when it’s time to deliver. It’s sometimes safer to deliver via C-section to avoid harming the baby during a vaginal delivery. Also, cesarean delivery is commonly scheduled for the birth of multiple babies, such as twins and triplets.

Another reason for a C-section is to avoid something called shoulder dystocia — a complication of vaginal birth. This is when the baby’s shoulder gets stuck in the pelvis on the way out. It’s not always easy to predict when this will happen, but it’s more common when the baby is very large or when the pregnant parent has diabetes or obesity. 

What are the risks of a C-section?

Because a C-section is a surgery, all the usual risks associated with surgery apply: 

• Infection

• Blood loss

• Injury to nearby structures (in this case, the bladder)

• Reaction to or side effects of anesthesia

More serious, but rare, complications of a C-section can include:

• Blood loss that requires hysterectomy or blood transfusion

• Blood clots

• Kidney failure

• Problems with wound closure

• Rupture of the uterus 

There are also risks to the baby in a cesarean delivery. For example, there’s a very small (1% to 2%) chance that the baby could be cut during the opening incision. The baby’s risk of breathing problems is also higher with cesarean delivery, especially if it is delivered before 39 weeks. This is because the labor process helps the baby clear amniotic fluid from its lungs. More research is needed to fully understand why. 

The risk of complications for parent and baby is higher when the C-section is emergent rather than elective.

What are the benefits of a C-section?

Aside from the risks and safety concerns already mentioned, another benefit of a C-section is that it provides an alternative to vaginal delivery. A C-section helps to avoid some of the complications of vaginal delivery, such as vaginal tearing, pain, and heavy bleeding. Up to 90% of people experience tearing during vaginal delivery, and most need stitches. Some experience tearing that extends all the way through to the anus. This is more common with large babies and first deliveries. 

Another consideration is the risk of pelvic floor disorders, also called pelvic support problems. These happen when the muscles at the bottom of the pelvis are no longer able to hold the pelvic organs in place. Problems include difficulty controlling your bladder or bowel and prolapse (when an organ drops down from its usual place in the pelvis). The baby’s weight, obesity, and pregnancy in general put you at risk for pelvic floor disorders. However, some studies suggest that there’s a lower incidence of pelvic support problems after C-section than after vaginal delivery.

What is the recovery process?

Because the two delivery types are so different, it’s no surprise the recovery is also different. If you have a C-section, it’s likely that your hospital stay will be a day or two longer (or even longer if there are complications). You should expect your overall recovery to be a bit longer as well. 

What to expect in the hospital

After delivery, you’ll be able to hold your baby right away. You can start skin-to-skin contact and breastfeeding as soon as you’re able. 

If you had a urinary catheter during surgery, it should be removed immediately afterward. Urinary catheters increase the risk of urinary tract infections (UTIs).

The anesthesia should wear off in a few hours. Until then, you might have some nausea. You can ask for nausea medication if you need it. In most cases, you’ll be able to eat something within a couple of hours. 

Your incision will be covered with a bandage, and it will be sore for a while. It’s not uncommon to need strong pain medicine for the first day or two. But after that, acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen should work well. Your healthcare team will keep an eye on your incision while you’re in the hospital. 

You’ll be encouraged to get up and walk around at least a few times a day. This is true for vaginal and cesarean delivery. When you get out of bed the first few times, be sure to ask for help. You might feel unsteady or wobbly. This is normal. 

After a C-section, you might also be afraid to move around because you’ll have pain from surgery. But moving around is really important: It helps prevent blood clots. You might be asked to wear compression stockings, which also help prevent blood clots.

Moving around also helps wake up your gut. Sometimes after surgery, the intestines slow down. This is important because you can’t go home until you have had a bowel movement.

What to expect at home

A unique part of C-section recovery is caring for your incision. It’s important to allow your incision to heal when you’re home. This means getting help and not lifting anything heavy for a couple of weeks. (Don’t worry, you can lift your baby.) You’ll also need to keep your incision clean and dry. Don’t soak in a tub or pool until your incision is completely closed. Your healthcare team will give you specific instructions before you leave the hospital. 

Expect to have soreness in your belly and at the site of your incision. This should get better each day. When you leave the hospital, you will get instructions on what to take for pain. This is usually acetaminophen, an NSAID, or a combination of the two.

Another difference is when you have a follow-up appointment with your obstetrician. After a C-section, this will happen at 2 weeks to check that you’re healing properly, and again at 6 weeks. Most people who deliver vaginally will follow up with their doctor at 6 weeks only, unless there are problems.

Similar to vaginal delivery, you will also have cramping and vaginal bleeding after a C-section. This will continue for 4 to 6 weeks, but it gets better with time. Don’t use tampons, in order to prevent infection. For this same reason, you should avoid having sex as well. Ask your provider when it’s safe to use tampons and have sex again.

Emotional recovery after C-section

Regardless of how you give birth, your mood and mental health may take a hit. It’s normal to feel many things — sometimes all at once — including: 

• Elated

• Overwhelmed

• Exhausted

• Anxious

It’s also difficult to know when these feelings are normal and when they are something more serious. There is no difference in the risk of postpartum depression between vaginal and cesarean delivery. 

How long does it take to recover from C-section?

As with any surgery, this varies from person to person. Most people will feel better 2 to 4 weeks after cesarean delivery. Less than 10% will still have pain related to their C-section 2 months later. A good estimate for total recovery is 6 to 8 weeks.

Allow yourself plenty of time before getting back to “normal” activities. It’s okay to do stretches for your neck and shoulders and to go for walks. But it will be at least a few weeks before you’re ready for more activity. Don’t drive if you’re taking narcotic pain medication. Speak with your obstetrician if you have any specific questions about what you can and can’t do. 

How can I speed up my recovery? 

Unfortunately, there are no secret tips or tricks to recovery. A common-sense approach is usually best. In other words, listen to your body. If something causes you pain or discomfort, don’t do it. Ask for help whenever it’s available, and say yes when help is offered. It might seem impossible, but try to rest as much as you can.

Are C-sections cheaper than natural births?

That depends. The costs of childbirth depend on several factors, including your insurance status, where you live, and how long you stay in the hospital, among other things. It’s always best to check ahead of time with your plan and the hospital where you plan to deliver.

Are C-section babies different?

As mentioned above, there is a risk of injury to the baby during cesarean and risk of breathing problems afterward. Some studies have found that babies born via C-section are at higher risk for allergies and asthma in the first few years of life. However, a definite cause has not been established.

How we decided 

Guidelines

We consulted with the Enhanced Recovery After Surgery (ERAS) guidelines from the American College of Obstetricians and Gynecologists (ACOG). ERAS is a standardized care program that advises on patient care for certain surgeries, with the goal of improving patient outcomes. These guidelines suggest ways to reduce complications after cesarean delivery. 

We also found guidance from ACOG and the Society for Maternal–Fetal Medicine, who wish to lower the rate of unnecessary cesarean deliveries. These societies suggest when cesarean delivery should be performed and how to balance risks and benefits. It should be noted that these are only recommendations: Each situation is different, and there is no one-size-fits-all plan for everyone.

Research studies

Research studies have observed aspects of vaginal and cesarean deliveries over the years. These include complication rates, recovery patterns, and long-term effects. These studies were helpful in guiding this answer page.

Keep in mind

One more thing to keep in mind with cesarean delivery is how it might affect your next pregnancy. Having a C-section may put you at risk for placental problems in later pregnancies. This risk increases with each cesarean delivery. 

Also, having a C-section may affect your future childbirth options, if you choose to have more children. For many years, you were told that if you’ve had a C-section, you should avoid vaginal deliveries for later births, no matter what. This is because there was a risk of the uterus rupturing along the old cesarean scar during a vaginal delivery. 

But now experts say vaginal birth after cesarean (VBAC) is acceptable in many situations. Although uterine rupture is still a risk, it is rare (less than 2%). Your childbirth options will depend on many things, including:

• How many times you’ve given birth

• How long ago your C-section was

• Where your previous cesarean incision was done

• Whether you have any problems during pregnancy 

VBAC should be done in a hospital, just in case complications arise. Speak to your obstetrician if you’d like to learn more.

Thinking about childbirth options might feel overwhelming, especially if it’s your first time. To be sure, you want to do what’s best for the baby and what feels right for you. It’s okay to ask a lot of questions. It’s important to understand the benefits and risks of both vaginal and cesarean delivery.

Vaginal delivery after having a C-section (VBAC) rose to 13.3% in 2018 from 12.4% in 2016.

What to watch for

If you have a C-section, it’s important to be on the lookout for concerning signs and symptoms during your recovery. If you have any of the following, be sure to contact your healthcare provider right away:

• Fever (temperature over 100.4°F)

• Redness, warmth, or pain at the incision

• Redness, warmth, swelling, or pain in only one leg

• Vaginal bleeding that is getting heavier or smells bad

• Shortness of breath

• Worsening pain

Last, let someone know if you are struggling with your mood or feelings. Help and support are available. Be sure to reach out, especially if you have thoughts about hurting yourself or your baby.

Why trust our experts?

Written by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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