Contents
Why natural childbirth after cesarean is dangerous: the main risks
Many women do not give up the hope of giving birth on their own, even after surgery. Is it possible to have a second child naturally if the first baby was born with a cesarean section? Let’s figure it out together with an expert.
Not a single doctor will simply answer this question. Previously, there was a prejudice that it was impossible to give birth naturally with a scar on the uterus. Modern medicine refutes this statement.
Theoretically – yes, it is possible to give birth naturally, even if the previous baby was born by cesarean section. However, whether this particular woman will be able to give birth on her own can be determined only after examining the condition of the scar on the uterus. It usually forms within two months after the surgery.
obstetrician-gynecologist, doctor of medical sciences, professor, chief physician of the EMC perinatal center
“It is important to know that if you have decided to become a mother for the second time without surgery, then you need to be prepared for the fact that the doctor will especially carefully monitor the course of your pregnancy. The focus of attention remains the state of the uterine scar: its usefulness is the main condition for the successful course of pregnancy and childbirth. “
There are other contraindications to natural childbirth: diseases of the cardiovascular system, vision problems, acute fetal hypoxia, a history of uterine rupture, etc. In some cases, doctors perform a caesarean section, which helps to avoid serious consequences for the health of the mother or child. If the gynecologist sees no threat, then he will always support a woman who decides to refuse the operation.
“Childbirth is a natural process that is necessary for a child to be born physiologically. Indeed, as it passes through the birth canal, its respiratory, cardiovascular system, etc. are being prepared. In addition, attachment to the breast in the first minutes of a baby’s life is useful for the formation of immunity, explains Natalya Kan.
When surgery is indispensable
“Vaginal birth after a cesarean section in history is 70-80% successful, so all women should know that this is more than possible,” the doctor said.
In this case, the gynecologist is also obliged to warn about all kinds of risks. The modern technique of the operation is significantly different from what it was 10 years ago. For example, high-quality polymer threads are used for suturing, which allow for better recovery after childbirth.
During the operation, obstetricians-gynecologists try to do everything to form less scar tissue. Despite this, in many women, after a cesarean section, an inferior scar on the uterus is formed, that is, in this area, the connective tissues become less elastic and do not tolerate serious stress. This type of healing is most likely to result in uterine rupture in a subsequent pregnancy or abnormal attachment of the fetus to the placenta.
If a woman wants to give birth naturally in the presence of a scar on the uterus, then a number of conditions are necessary:
One history of cesarean section with a transverse incision in the uterus in the lower segment.
Lack of obstetric indications that served as indications for the first operation.
Uncomplicated postoperative course.
Assumption of the usefulness of the lower uterine segment (based on the results of clinical and instrumental studies).
Localization of the placenta outside the uterine scar.
Features of pregnancy with a scar on the uterus
The operation transferred in the past cannot in any way affect the conception. As soon as you see two strips on the test, you must immediately register with the antenatal clinic.
Next, you must be prepared for special control by doctors. For example, you will be given an ultrasound scan much more often (especially in late pregnancy). It is important that there are no complications. For example, with high water, the walls of the uterus will stretch faster, and such loads are undesirable for the scar.
As a result, the decision on whether a woman can give birth herself after a cesarean is made by the doctor together with the patient. The expectant mother should understand all the risks that are in her particular case, the doctor informs about the state of the scar on the uterus and about the possible course of childbirth. And then you just have to wait.
“We prefer that labor began naturally, without stimulation,” says Natalia Kan. – If a woman is very worried, then some medical centers provide an opportunity to go to the hospital in advance. The expectant mother is actually waiting for the start of labor already in the hospital and can be completely calm about her health and the health of her child. “