Pain is so subjective, isn’t it?
Some women say childbirth is the most painful thing they’ve been through.
Others say that giving birth naturally was the best experience and they would do it all over again.
If you listen to women who have experienced both vaginal birth and c-sections, you will find different opinions about which was the less painful experience.
Let’s explore some facts about which of these births is more painful: natural birth or c-section.
Pain in childbirth
Pain is the body’s way of letting us know something isn’t functioning as it should.
Most physical pain we experience is considered pathological. That means it is a symptom of physical damage, disease, or illness. Pain is the result of illness, disease, or injury.
There’s only one type of pain that’s the result of your body’s normal function (physiological) and that’s labor pain.
Pain during childbirth is normal and has a purpose. During pregnancy the cervix is tightly closed; for your baby to be born, it needs to open. For the cervix to open, the uterus must contract, and then push the baby down through the cervix and vagina.
As labor progresses, the contractions become more intense and can be perceived as more painful.
Health care providers who view childbirth as a normal life event agree that pain during labor has a very important mission: to make a woman adopt the right position to ease the baby’s passage through the pelvis.
What causes pain during labor?
We know that fear plays an important role in our perception of pain.
We know where and how we give birth has a big influence on how we feel the pain of labor. Birthing in a supportive environment, surrounded by the right people, can lower pain perception to the point where some women experience pleasure rather than pain.
You can read more about this in Undisturbed Labour – What Is It And Why Aim For One?
The pain a woman feels during the birth of her baby will change, depending on the stage of labor she is in.
At first, your uterus muscles will contract, to begin the process of opening your cervix. These contractions will increase in intensity and strength, until your cervix is fully dilated to allow your baby passage through.
You feel the pain associated with these contractions mostly in the pubic area, where the cervix is, but also in your back and down your thighs.
The position your baby is in when he enters the pelvis will also have a great impact on your pain.
C-section vs vaginal delivery: which is more painful?
Without the use of some type of anesthesia or pain relief, we’ll agree c-section births are a lot more painful than vaginal delivery.
It’s believed the very first c-sections were done on women who died during childbirth. It’s hard for us to know whether the c-sections were done to save the baby or for religious reasons; the truth is now lost in the mists of time.
If you’re interested in knowing more, BellyBelly’s The Gruesome Origin Of C-Section Birth has lots of interesting facts.
The first c-sections done on living women didn’t involve any type of anesthesia – something we wouldn’t even consider today. Having major abdominal surgery without anesthetic would be incredibly painful.
When asking the question: ‘Which type of delivery is more painful?’, we’re comparing a c-section done under full anesthesia with a vaginal delivery using no pain medicine or pharmacological pain killers.
The answer to this question seems quite obvious: a c-section delivery means you’re unable to feel anything while the baby is being born. The obstetrician takes care of the surgery and the anesthesiologist makes sure you’re pain-free and can’t feel a thing.
Is c-section better than vaginal delivery?
If we think of a c-section delivery as starting from the first incision until the last of the sutures is finished, we could argue that it’s less painful than vaginal birth.
Vaginal delivery begins with the first uncomfortable contraction, and continues through all the more intense dilating contractions until the baby and placenta are born. A normal vaginal delivery doesn’t involve the use of drugs to numb the sensations of contractions.
We know that both c-section and normal vaginal delivery entail much more than just the procedure on its own.
Many women choose vaginal births to avoid the risks of having major surgery. Likewise, there are women who choose surgical births because they’re afraid of the pain of natural birth. Plenty of women choose vaginal birth after cesarean (VBAC)
Why does anxiety intensify pain?
We know anxiety and fear have a great impact on our perception of pain. They can play an important role in our expectations for natural birth.
Previous birthing experiences, or what friends and relatives have told us about their pain experience in labor, can really affect how we perceive the pain in our own bodies.
If we are afraid of going through labor naturally, we’ll very likely face it with a very tense body and our perception of pain will be increased as we experience labor.
Muscular tension makes the contracting and relaxing of the muscles much more difficult. Dilation of the cervix will be more painful in these conditions.
When a woman is tense during labor her pain threshold will be very low, as her muscles can’t work properly due to the added tension.
This will make natural birth more painful than it otherwise would be.
Having a planned c-section might seem to be the right answer for those expectant parents who are fearful of normal labor and birth. But the effects of surgery and the recovery time on the overall pain experience must also be taken into account.
When a c-section isn’t planned (emergency c-section), you’re already likely to be under a certain amount of stress. You might be worried about your baby, scared about being in more pain than you can handle, or fearful of having surgery.
The stress raises your blood pressure and adrenaline levels and can increase your perception of pain. High blood pressure isn’t something you want at any time during labor, birth, or afterwards.
When this is the case, your perception of pain will also be heightened after the surgery is finished. You might require more pain relief than is usual after a c-section because you feel as though your pain level is higher.
What pain is normal after c-section?
A c-section is major abdominal surgery, and has a longer recovery time than a physiological vaginal delivery.
The c-section incision cuts through various abdominal layers and each one of them needs to heal. The incision site will feel tender, bruised, or painful for some time.
At the same time, as you’re no longer pregnant after a c-section delivery, you’ll experience early postpartum changes.
Your uterus has quickly gone from being full-term pregnant to being non-pregnant, and it has been surgically opened. If you had an emergency c-section your uterus and cervix have also been affected by the previous contractions and labor.
Now your uterus must contract down to avoid excessive bleeding. This return to pre-pregnant size happens with regular contractions, called after pains. These uterine contractions can be quite intense and will add to your overall discomfort.
Once your epidural or spinal block starts to wear off your anesthesiologist will make sure your pain is well managed and will prescribe different pain medication for you to take, as necessary.
Every health care provider involved in a woman’s recovery will make sure her pain levels are within manageable limits.
Women who have had c-sections are encouraged to get out of bed within 24 hours. Although this might seem early, it’s important for many reasons. It helps to reduce the risk of blood clots and other heart or blood vessel problems.
When is c-section pain the worst?
Typically it’s expected a woman will feel the worst pain after her anesthetic wears off, around 18 hours after the c-section. Usually, at this point, you are either given a patient-controlled medication device that delivers medication through an IV, or your doctor will determine the best way to manage your pain.
How long does c-section pain last?
How long the pain of c-sections can last will vary a lot between women. There are many factors that influence this, including: your pregnancies; your surgeon; whether it was a planned or emergency c-section; postpartum recovery; and medication.
Usually, after c-sections, women should feel better as time passes. The first week after surgery is the most painful, as everything is so recent and fresh. The pain should ideally ease off week by week.
Most women are considered fully recovered from an uncomplicated cesarean section six weeks after the birth of their baby.
Which heals faster c-section or natural birth?
When vaginal births and cesarean sections are straightforward, with no complications, experts agree a normal vaginal birth is easier and faster to recover and heal.
Our bodies are designed to give birth and, in normal circumstances (that is, allowing the body to do what it naturally knows how to), a woman will heal faster from a vaginal birth than from a surgical procedure.
Unfortunately, not every vaginal birth progresses normally. There are some serious complications that can happen during the normal birth of a baby. These are rare, but they increase the length of time needed to heal.
Severe tearing, or perineal trauma, happens when the area between the vagina and anus is torn; this usually involves skin but sometimes muscle tissue as well. When the perineum suffers severe tearing it will need to be surgically repaired and strong pain medication will be prescribed.
Compared with this case, recovering from a straightforward c-section might be easier, faster, and less painful.
Your biggest asset for a speedy recovery after a normal birth is oxytocin. This hormone that facilitates strong and effective contractions during labor and, after the placenta is delivered, helps stop excessive bleeding.
One of the biggest oxytocin surges in your body will happen right as your baby is being born, during an undisturbed labor.
During labor, oxytocin levels climb until receptors in your vagina are triggered by the passage of your baby. Close contact with your baby after birth will keep these levels high, preparing you and your baby to fall in love with each other.
This is why it’s recommended parents have immediate skin to skin after birth, to keep their baby close and promote this wonderful oxytocin surge.
Bonding between a mother and her baby not only helps them both establish a healthy and loving relationship, but also keeps those doses of oxytocin topped up.
This constant flow of the ‘love hormone’ will be topped up every time you’re close to your baby. Smelling your baby, feeding her, practicing skin to skin, caressing your little bundle of joy will make sure oxytocin keeps flowing in your bloodstream. This will help your healing mechanisms to perform at their best.
A cesarean section doesn’t facilitate this final oxytocin peak. Bonding and attachment can be affected – especially if babies and mothers are separated after the delivery. This can affect the emotional recovery of women and, therefore, their physical recovery.
Would you rather have a c-section or natural birth?
This question will have different answers depending on the individual circumstances each woman faces.
Vaginal birth is the normal, physiological way nature intended our bodies to give birth. Being informed about how your body works during labor, and being supported to achieve a normal birth, should be the preferred choice for most women.
Overall, natural birth has more health benefits for mother and baby, and the recovery time is reduced. There is also an overwhelming sense of empowerment and achievement when a mother births her baby naturally.
A straightforward uncomplicated c-section can be also a very rewarding experience for many women – especially if they have previous birth trauma or misconceptions about the pain of normal birth.
Emergency c-sections can be a bit frightening but, if a woman is empowered to make informed choices, then that experience can also be rewarding.
Both birthing methods entail different risks and you should discuss them with your health care provider. Choosing the right environment and professional support will help you understand both procedures better and make an informed choice when considering one method over another.
If a mother chooses to have an elective or planned c-section, having knowledge about how to have a gentle c-section can be a good way to limit pain and anxiety and improve recovery.
If you choose to have a natural birth, the development of a birth plan or the services of a doula will help you feel more empowered and relaxed when labor starts, and this will allow a natural oxytocin flow.