Assumption: A cesarean birth is safer than a vaginal birth for moms carrying twins.
According to this study of 2,800 women, planned cesarean birth is no safer than planned vaginal birth for twins.
So many moms carrying twins are told that they have no safe choice other than cesarean surgery. Because of the threat to their babies many moms feel they can’t even attempt vaginal birth in good conscience. This study proves otherwise! I hope that moms of twins will have the option of finding a doctor who will be willing to plan on a vaginal birth, knowing she is not putting her babies at risk. FYI, this study did limit itself to situations in which the first baby was head-down, so a breech twin birth is another matter altogether!
Assumption: Incontinence and other pelvic floor disorders are more common after a vaginal birth than a cesarean birth.
This study says that pelvic floor disorders are more common in women who have delivered vaginally than in those who have had cesarean sections or who have not given birth to a baby larger than 2 kg.
Emily S. Lukacz, MD, Jean M. Lawrence, ScD, MPH, et al., Parity, Mode of Delivery, and Pelvic Floor Disorders, Obstet Gynecol 2006;107:1253–60
Unfortunately, this study actually gives us almost no usable information. While it does come to the conclusion listed above, there are many events that contribute to pelvic floor dysfunction that were not considered as a part of the study. There are so many differences in vaginal births that lumping them all together for a study like this actually makes the results unusable. The authors of the study themselves assert, “we did not attempt to further delineate delivery events, such as episiotomy, assisted delivery, and birth weight, for the primary analysis.” Episiotomy (an actual CUT in the pelvic floor) and assisted delivery (putting an instrument inside the woman to pull the baby out) are going to make a huge difference in how the pelvic floor heals! I would also like to know which of the women with pelvic floor disorders pushed while on their backs (“uphill”) and which used a more gravity-friendly position to push the baby out. I’d like to know which were coached to push and hold as told and which were able to push with their body’s own urges. If you pulled out the women who gave birth vaginally with no episiotomy, no instruments, no coached pushing, and a gravity-friendly pushing position, how many have pelvic floor disorders? I’d like to see this group compared to the cesarean moms and those who have not given birth. This is the only way we could determine whether vaginal birth itself is to blame for pelvic floor dysfunctions or whether it is our society’s version of a vaginal birth that is to blame.