Caesarean section by choice is on the rise in South Africa.

About three in 10 women now opt for an elective Caesar because of the convenience - and because they fear childbirth.

Many women shun natural birth because they believe it stretches the vagina. They also believe that they run a high risk of disability or death while pushing the baby out.

Studies show that some natural birth and delivery factors increase the trauma to the perineum. These include having a big baby, pushing for more than an hour, the use of forceps and tearing.

In spite of this, some women still believe natural birth is the way to go.

The reigning Miss Globe, Doris Msibi, said the healing process was faster, the procedure was healthier and natural birth connected the mother to the baby more strongly than a Cesarean section.

"I'm an old-fashioned girl. I love doing things naturally. Going through the pain of childbirth made me more conscious of my womanhood."

She said the story about vaginal expansion was a myth.

"My vagina went back to its normal size after two weeks. My love life improved."

Tshedi Mholo, of Malaika, said that if she had her way she would have gone natural.

"My reasons for having a Caesarean section were purely medical. My bones were a bit tight for my baby to pass through. A lot of people think a Caesarean section is a pain-free way to give birth but the effects are lasting. It leaves you with a scar that can be removed only by plastic surgery."

Augustine Masilela-Chuene said that after losing her first baby through complications she decided to give birth by Caesarean section.

"I had no option. I had lost my first baby so I decided to go the Caesarean way. With my first baby I nearly died.

"All my organs fell apart and I had high blood pressure. If I'd had my way, I would have had a natural birth."

Amos Angori, a gynaecologist, said Caesarians were on the rise because a lot of women, especially first-time mothers, had an extreme fear of childbirth.

"Young and first-time mothers experience fear about natural birth. A lot of them ask me to operate on them."

He said some women ask for a Caesarian so that they can schedule the baby's birth date for their own convenience.

Risks and complications for the mother

(most of them associated with any type of abdominal surgery):

Infection: Can occur at the incision site, in the uterus and in other pelvic organs.

Increased blood loss: This can lead to anaemia or to a blood transfusion.

Injury to organs such as the bowel or bladder.

Adhesions: Scar tissue might form in the pelvic region, causing blockage and pain.

Emotional reactions: Some women report feeling negatively about their birth experience and having trouble bonding with their newborn.