Natural delivery after cesarean section: is it recommended?

Many people think that it is impossible to have a natural delivery after a C-section. That's not true. In fact, most women do and this is not only possible, but also convenient.

It is estimated that up to 75% of women can deliver naturally after cesarean section, or vaginal delivery after cesarean section (VBAC) as it is known in the medical world. In any case, each woman, together with her doctor, must decide whether this is the most appropriate in each case.

Vaginal delivery has significant advantages, since it supposes less risks for the health of the mother and the baby. However, in some cases it is not convenient for various reasons. So the indicated thing is to assess each case individually.

Reasons why you might opt ​​for a natural delivery after a cesarean section

It is possible to have a vaginal delivery after a cesarean section. Check with your doctor about it.

There are several reasons why attempting a natural delivery after cesarean section would be justified. The most relevant are the following:

  • Surgical complications. A cesarean section carries higher risks of heavy bleeding and deep vein thrombosis; that is, from the formation of blood clots in the deep veins.
  • Lower risk of infection. Cesarean section carries higher risks of infection.
  • Lower risk of injury. In some cases, a cesarean section can damage the abdominal organs, such as the bladder or intestine.
  • Decreases the risk of hysterectomy. Natural childbirth reduces the risk of complications leading to removal of the uterus, or hysterectomy.
  • Protection for subsequent pregnancies. Multiple cesarean deliveries can cause problems such as the placenta previa (detachment) or the placenta accreta (attachment to the uterine walls), which in turn complicate subsequent deliveries.
  • Faster recovery. Cesarean section requires a longer hospital stay, greater care, and therefore a longer delay in returning to normal activities.
  • Personal preferences. Some women want to experience the vaginal type of delivery and can do so, even if they have had C-sections before.

A comprehensive study of Leeds University Hospitals notes that cesarean delivery is associated with higher maternal and neonatal mortalityas well as further complications in the mother's reproductive health.

Who can have a natural birth after cesarean section?

Not all women can have a natural delivery after cesarean section. There are some exclusion criteria that are applied to avoid risks. One of the most important is the state of the uterus.

Read also: Induced labor: what is it and how is it done

It influences, for example, the type of incision that was had in the previous cesarean section. Those who had a vertical incision in the upper part of the uterus are not candidates for a vaginal delivery. Neither do those who have had uterine surgeries or have a history of uterine rupture.

Other exclusion criteria are the following:

  • Having had a cesarean section 18 months or less ago.
  • Not having been able to have a natural delivery before.
  • Present problems in the placenta.
  • Having placed the baby in an abnormal position.
  • Having a multiple pregnancy.
  • Presence of a disproportion between the size of the baby and the mother's pelvis.
  • Plan to give birth in a place other than a hospital.
  • When labor induction is needed.
  • Elderly mothers.
  • Overweight or obese
  • Preeclampsia.

Some experts include among the exclusions having had two or more caesarean sections before. Nevertheless, a study from the University of Washington School of Medicine revealed that this does not involve serious risks. However, the issue remains controversial.

Risks of a natural birth after a cesarean section

There are some risks associated with a natural delivery after a cesarean section. Consult your doctor about it.

A natural birth after a cesarean section carries several risks. The most serious of them is that the uterus ruptures. This occurs only in 1% of cases, but it is very dangerous, as it threatens the survival of the mother and the baby.

It occurs when during a natural childbirth the scar from the previous cesarean section breaks and the uterus opens. If this happens, an emergency cesarean section should be used to save both their lives. In some cases, this includes the removal of the uterus, which makes it impossible to have children again.

The risk of rupture in the uterus during a natural delivery after a cesarean section is much lower in women who had a transverse incision in the previous cesarean section. Hence, it is so important to exclude the group of women who had a vertical incision in the uterus.

Is it possible to have a natural birth after cesarean section?

If a woman plans to have a natural delivery after a cesarean section, you should tell your doctor well in advance. It is important that you report all your medical history in detail.

With accurate data, the doctor can make a realistic estimate of the probability of success and possible risks. The mother must be well informed about the benefits and possible dangers to opt for this alternative.

The benefits of natural childbirth are many, but it is important that the mother has an open mind to the different possibilities. If in your case it is not convenient, do not be obstinate. The most important thing is to preserve your safety and that of the baby on the way.

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