In detail

Vaginal birth after caesarean section

Vaginal birth after caesarean section




Advantages and disadvantages
If you have already had a baby by Caesarean section, do not consider a vaginal birth to the next child. Many women give birth to a vaginal child after giving birth by Caesarean section. But besides the benefits of vaginal birth after cesarean section, there are risks that you must be aware of. Read about them and then talk to your obstetrician.
Who can give birth after Caesarean section?
Of the women who try to give birth after a caesarean section, only 60-80% succeed. The rest ends by doing everything Caesarean. If you are healthy and there are no risk factors, then a vaginal birth after cesarean section (NVDC) is possible if your obstetrician also agrees.


Benefits
There are several reasons why you want to try NVDC. Some women will simply experience vaginal birth. There are also medical reasons why this variant attracts women:
  • Elimination of the need for an abdominal operation that has associated risks (eg infection, bleeding and complications related to anesthesia)
  • Reducing the risk of a possible blood transfusion, thus reducing the risk of a blood disease
  • Decreased post-partum hospitalization period
  • Shorter recovery time
    Risk factors
    The main risk factor is the possibility of uterine rupture. Uterine rupture can threaten the life of both the mother and the baby. The probability of a uterine rupture is low, but because it is a serious situation, your risk should be carefully evaluated by your doctor. Experts say that the risk of uterine rupture increases especially if you have to induce labor.
    The risk is different depending on your previous births, the duration of labor and other factors that your doctor will find after deciding whether or not you are a good candidate for NVDC.
    It seems that the risk of infection for the mother and child is higher in cases where a vaginal birth after Caesarean section is attempted followed by another Caesarean section.
    If you still opt for this option, the maternity ward must be equipped for emergency caesarean section in cases where it is needed.
    Is NVDC a good option for me?
    You need to consider several aspects to see if you are a good candidate for NVDC or not. Your doctor will tell you if it is too risky after analyzing:
  • Type of incision: If at first caesarean section the incision was made vertically ("classic"), by vertical cutting of the upper part of the uterus, the risk of uterine rupture is higher than if the incision was made horizontally or vertically at the bottom of the uterus.
  • Number of previous cesarean operations: The risk of uterine rupture increases with each additional cesarean section.
  • Time period that has elapsed since the last Caesarean section: Ideally, the next child should have been conceived at least 9 months after the last Caesarean section. The longer your body has time to recover from the surgery, the stronger it will become for the next birth.
  • Baby size: Another important aspect is the size of the baby compared to the size of your pelvis. If the baby is older, your uterus may be under prolonged stress during labor and will not progress normally. Your doctor can evaluate the size of the baby compared to that of the pelvis by ultrasound ultrasound.
  • Problems for the baby: There may be factors that indicate possible complications during the birth of the child (for example, the baby should be seated inversely and the seat first removed), which combined with other risk factors of a previous caesarean section can make NVDC too risky.
  • Placental problems: If you have placenta previa (placed too low) or placenta abruptio (separation of the placenta of the womb), it may be too risky to give birth vaginally.
  • Health status: If there are serious medical or obstetric conditions at the time of birth, your doctor will advise you not to give birth vaginally.
    Most of these risk factors can be identified before birth. So you can discuss your options in detail with your doctor.
    How to proceed?
    Only you can decide this with your doctor. You need to consider the advantages and disadvantages and take into account the advice of the doctor.
    Alina Sica
    Editor
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