In previous years, it was thought that normal birth would not be possible after cesarean section, but today we know that this is possible. Here, when labor pains begin, there is concern that the stitches in the uterus may tear due to the previous cesarean section. If a rupture occurs, the baby may come out of the ruptured uterus, and therefore the baby passing into the abdominal cavity will be noticeable, and if an emergency caesarean section is not performed, there will be a life-threatening situation. If the tear in the uterus cannot be repaired in surgery, the mother may need to have her uterus removed. However, today we know that while these risks are high in some patients, they are very rare risks, only four in a thousand pregnancies, in suitable patients. For this reason, normal birth after cesarean section can be performed safely and successfully in patients who meet the appropriate criteria. Because if these patients do not consider normal birth and perform a direct cesarean section, there will be situations that are more risky than four in a thousand. The most important factor affecting the success of normal birth after cesarean section is having had a normal birth at least once before. The patient, who had a normal birth in her first pregnancy and a cesarean section in her second, will be a suitable candidate for normal birth in her third pregnancy. The number of previous cesarean sections is important. It is ideal for the patient to have had a cesarean section once, as the potential risk during birth increases as the number of cesarean sections increases. When this number increases to two or more, the risk increases slightly. Spontaneous onset of labor pains is also one of the factors that facilitate normal birth after cesarean section. Artificial pain is not used in normal birth after cesarean section, except in rare cases. Therefore, the patient's labor pains must begin spontaneously. The mother's body mass index is also important.
Normal birth after cesarean section should not be attempted in patients who have previously undergone swimsuit surgery, as it is risky. In a cesarean section, a horizontal incision is usually made in the lower part of the uterus and the baby is removed. Sometimes, in cases where it is difficult for the baby to come out or if the placenta does not close down or prevents the baby from coming out, the upper part of the uterus can be cut and removed. Although this situation is not common, if an area from the upper part of the uterus was cut in the previous cesarean section, it may also be due to labor pain in these patients. Since the risk of rupture in the uterus is very high, normal birth should not be attempted after cesarean section. The baby should be delivered by cesarean section in a planned manner. When making a decision after a cesarean section, the most important thing is to talk to the family and make a joint decision. A mother who has previously had a negative normal birth experience or who wants to have her tubes tied at the same time may prefer a cesarean section.
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