Release Date: 5/30/2014
Giving birth again after a C-Section
Dr. Anita Schnapp
By Dr. Anita Schnapp, St. Anthony’s Medical Center
It is a question I often hear from patients who have had a Cesarean section and have learned they are pregnant again: Can I have a vaginal delivery after a C-section?
Each patient has her own reasons for choosing a vaginal birth after a cesarean or a repeat C-section, and there is not one right answer to this question. The decision may be based on health, emotional or practical issues. Some women feel a strong desire to give birth vaginally. Others may like the ability to plan the timing of a repeat C-section. For other women, a negative experience with the previous delivery may sway their decision. Often, a medical complication encountered in the previous delivery is the main factor in the decision.
According to the National Institutes of Health VBAC (Vaginal Birth After Cesarean) Consensus Statement, about 74 percent of women who plan a VBAC will be successful. The success rates vary for several reasons, including the health of the mother, her vaginal birth history, the reason for her prior cesarean, the length of the pregnancy, and induction of labor. If successful, a VBAC also offers several benefits for the mother: ability to breastfeed sooner, quicker recovery, fewer incisions and less scarring, and a greater participation in the birth. However, there are risks to a failed vaginal birth after cesarean, including a slight risk of uterine rupture. In addition, a Cesarean after a trial of labor increases the risk of infection for both the mother and baby.
Some things to consider as you are deciding how you want to bring your baby into this world:
- Have the conversation with your physician early in your pregnancy. If you are considering it, you want to be sure your physician will support it, and that it is allowed at your delivery hospital.
- If you have done it before, you may be able to do it again. While there are no good tools to predict who will have a successful VBAC, a previous vaginal delivery definitely works in your favor.
- You may have closer monitoring during your labor than you did previously. I would be quicker to intervene on a VBAC regarding questions about the baby’s well-being, because it could be a sign of uterine rupture.
- Consider not just the labor experience but also recovery when making this decision. The recovery for a C-section can be harder, and might include internal scarring down the road.
- Delivery route may also have effects on future pregnancies. The more C-sections a woman has, the more likely it is that there can be a placental problem, uterine rupture or scarring in the abdomen that can lead to complications with future C-sections.
Remember that the goal of a pregnancy is a healthy mom and healthy baby, regardless of the route by which that is accomplished. Both vaginal and cesarean can accomplish that goal.
Dr. Anita Schnapp is a St. Anthony’s obstetrician/gynecologist.
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