Natural Birth or C-Section?

There are two good ways to give birth: natural childbirth (vaginal delivery) and cesarean section. Sometimes the medical situation determines which option is right—and you always have a say in the decision. It’s important to us that you’re well-informed and can make your choice without pressure. We’ll discuss this with you at your leisure during your pregnancy; the birth itself will take place at the hospital to which we refer you, or where the affiliated physician we’ve arranged for you practices.

Vaginal Birth

Vaginal birth is the natural way to give birth to a child, and for many women, it is the right choice. Its advantages include: generally faster recovery, no abdominal incision, an intact uterus for future pregnancies, and, for many women, an intense birth experience. However, we must mention that a planned vaginal birth does not always go as expected; about one in ten ends with the use of a vacuum extractor or forceps, and about one in ten with an unplanned (emergency) cesarean section. This is not a failure, but part of the natural unpredictability of childbirth.

The Cesarean Section

In a cesarean section (sectio), the baby is delivered through a horizontal incision in the lower abdomen. Today, it is a safe routine procedure and usually takes 25 to 40 minutes. Except in emergencies, it is performed under regional anesthesia (spinal or epidural); you will be awake, your partner can be present, and the baby will be placed in your arms quickly. A cesarean section is clearly indicated when a vaginal birth would be too risky for the mother or the baby—for example, in the case of a transverse presentation, a placenta previa, or certain complications during labor.

Scheduled and Elective Cesarean Sections

If it is determined in advance that a cesarean section is advisable, we schedule it—preferably around the end of the 39th week, because the baby is then fully developed and temporary lung adjustment problems are rare. A cesarean section is also possible at your well-informed request (elective cesarean section). It is important to us to weigh the options honestly rather than make a blanket recommendation:

• For the mother: The main argument in favor of a planned cesarean section is better protection of the pelvic floor (reducing the risk of later involuntary urine or fecal leakage). Arguments against it include the risks associated with surgery and—for future pregnancies—a slightly increased risk of placental abnormalities. A planned cesarean section also offers a level of predictability that spontaneous birth can never fully provide: It avoids the—rare—situation in which a vaginal birth unexpectedly and rapidly turns into an emergency, which can be stressful and traumatic for both mother and child.
• For the baby: With good planning (at 39 weeks or later), the difference is minimal; a cesarean section scheduled too early is more likely to cause temporary breathing problems.

Which approach is right depends not only on statistics but also on your values and your life situation. Especially for women who have had a long or difficult journey to pregnancy—such as after fertility treatment—the desire for the greatest possible safety for the child is particularly understandable. We take these considerations seriously and support your informed decision (Cesarean Section Guideline).

Vaginal Birth After Cesarean (VBAC)

In the past, the rule was: once you’ve had a cesarean, you’ll always need one. That’s no longer true today. Many women who’ve had a cesarean can give birth vaginally the next time (known in medical terms as VBAC, vaginal birth after cesarean). According to statistics, this is successful in 50–70% of cases. The main risk is a tear in the cesarean scar on the uterus (uterine rupture): At about 0.7%, it is rare but serious—by comparison, the risk for a planned repeat cesarean section is around 0.2%. For this reason, a vaginal birth after cesarean section should only be performed at a hospital that can quickly perform an emergency cesarean section at any time—not at home or in a birthing center. We will decide together whether a VBAC or a planned repeat cesarean section is the better option for you, based on your medical history and your preferences (SGGG Guideline).

An easy-to-understand information sheet from the SGGG summarizes the most important points for pregnant women who have had a cesarean section: SGGG Information Sheet (Update 2024).

How We Support You

There is no single “right” way to give birth for everyone. Our role is to honestly explain your options, assess your personal situation, and support you in making the decision that’s right for you. The birth itself takes place at the hospital to which we refer you; there, you’ll meet the team that will support you, and the final decision will be made together. Both methods of delivery—vaginal birth and cesarean section—have their advantages and disadvantages, and both are covered by basic health insurance; therefore, costs should not influence your decision.