• Dr Peter Chew

Natural Birth – Any risks to the mother?

Natural Birth or vaginal birth refers to delivery via the normal birth passage. It is a natural physiological process and in most situations, is a safe and preferred way of giving birth.

Compared with caesarean section which is a delivery by abdominal surgery, vaginal birth carries much less complications to the mother. These complications can be divided into immediate and late complications.

Immediate complications include:

· Injuries to the soft tissues: Tears from the stretching of the vagina by the emerging fetal head and/or cut from the episiotomy to enlarge the birth passage can occur in the vagina, perineum (area between vagina and anus), urethra (urinary passage) and anus. The tears may be small or extensive with varying amounts of bleeding. The damage is usually aggravated by assisted deliveries using forceps or a vacuum cup.

· Injuries to the perineal blood vessels: If the bleeding is not stopped in time by careful stitching, accumulation of the blood clots can occur around the vulva resulting in extensive bruising or the formation of a haematoma.

· Injuries to the surrounding organs: Bladder injury can result in difficulty or inability to urinate or incontinence (leaking urine). Injuries to the anus and rectum can cause inability to control defecation (faecal incontinence).

Late Complications include:

· Prolapse of the uterus: Sagging of the womb can result from weakening of pelvic floor muscles and is more common in women who have delivered many children.

· Incontinence of stool or urine: This can occur after deep tears in the vaginal walls which go unnoticed at that time. These tears cause infection and subsequent scarring around the bladder and rectum. resulting in incontinence. Direct damage to the muscles controlling the openings of the anus or bladder can also be the cause of incontinence.

· Sexual dysfunction: Vaginal scars can cause pain during sexual intercourse. A loose vagina from weakened pelvic muscles may reduce sexual pleasure in some women.

· Psychological trauma: The unpleasant experience of vaginal birth and fear of getting pregnant again may result in difficulty in vaginal penetration (vaginismus) and/ or reduced sexual desire.

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Other related articles are

Vaginal Delivery

Caesarean-section vs Vaginal-delivery

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