“My first birth was a cesarean section. Can I have a normal second birth?” is a question frequently asked by my patients, I will try to briefly explain the answer to this question in my article this week.
Do I have a chance of having a normal birth after cesarean section and if so, how much?
First of all, it is evaluated really well and I am determined to be 'suitable' for normal birth after cesarean section. We know that patients who are determined to have a normal birth have a very high chance of achieving normal birth, that is, 60-80%. How do we decide if a patient is suitable for normal birth after cesarean section? First of all, there are many factors such as the number of previous pregnancies, whether she had a normal birth, if so, the weight of her babies, whether she had a difficult birth or an interventional birth, why she had a cesarean section, how many years ago the cesarean surgery was performed, how it was done, whether she had any other uterine-related surgery other than cesarean. For example, a patient who had a normal birth before and had a cesarean section in her second pregnancy, for example because the baby was breech, has a higher chance of having a normal 3rd birth than a patient who had a cesarean section in her first pregnancy due to a narrow birth canal or a long labor.
As I will explain later, due to risks such as uterine rupture that endangers the lives of the mother and the baby, only a limited number of patients are considered suitable for normal birth after cesarean section and it is only possible in a limited number of hospitals where very special conditions can be met. .
Which patients are suitable for normal birth after cesarean section?
If you have all of the following conditions, you are considered a suitable candidate for normal birth after cesarean section.
• If you have had a cesarean section only once and your surgery is old. If the method is not done (with the classical method). If you have had more than one cesarean section, if you have had myoma surgery before, if there was a T-shaped tear during the first cesarean section, the possibility of uterine rupture is higher. If you have not had a uterine rupture or separation before
• If you do not have any additional disease or other pregnancy-related problems that would make vaginal birth risky.
• Continuously monitor your birth If there is a gynecologist, an anesthesiologist and a healthcare professional who can perform an emergency cesarean section when necessary.
What are the benefits?
Normal birth after a successful cesarean section can prevent you from having a second surgery. Thus, you have the advantages of normal birth; such as less bleeding, less infection, no anesthesia risks, shorter hospital stay.
If you are planning to start a large family and want to have many children, as it is known, you have a limited number of cesarean section rights. However, when you give birth normally, you have the chance to give birth as many times as you want. In addition, in repeated caesarean sections, undesirable situations such as the baby sticking to the walls of the uterus and not being separated, excessive bleeding, bladder and bowel injury, and removal of the uterus occur.
If having your first birth by caesarean section makes you feel unhappy and unsuccessful, you will feel better if you can have a normal birth. Another benefit that can be considered is that you feel better.
What are the risks?
Even if you are a suitable candidate for normal birth after cesarean section, there is a 1% chance that the uterus will rupture, causing serious blood loss for the mother, the uterus being removed, and the baby dying due to lack of oxygen.
If artificial pain method is used during normal birth, the rate of uterine rupture increases even more.
Of course, if there is no successful vaginal birth, an emergency cesarean section is required. We know that the risks of a planned cesarean section are much less than those of an emergency cesarean section. Risks such as higher bleeding, infection risk, and blood transfusion are higher in emergency cesarean section.
The possibility of serious neurological sequelae and death for the baby is higher in normal birth after unsuccessful cesarean section.
How should it be followed up when normal birth is attempted after cesarean section?
The baby's heartbeat and uterine contractions should be constantly monitored by applying NST during the entire labor.
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