We used to have the rule "Once a cesarean equals always a cesarean." So this meant: A woman who once gave birth by cesarean section always had to give birth by cesarean section. However, with the currently developing surgical techniques and the development of technology, if you have had a cesarean section once, you can have a planned cesarean section again or you can have a vaginal birth after cesarean section.
“Post-Cesarean Vaginal Birth” (VAC) is based on mutual trust between the patient and the doctor. It is a decision. The risks must be discussed openly and the birth must be in a center where the anesthesia team is available 24 hours a day, the operating room is active, and there is a neonatal intensive care, adult intensive care and blood center.
The most feared issue in this decision is; uterine rupture. Although the risk is not very high (0.5%); If it occurs, it carries life-threatening risks for both the mother and the baby. The type of incision you had in your previous caesarean section is the most important issue in this regard. In the past, the uterus was cut vertically during a cesarean section. This incision is the one with the highest risk of rupture and normal birth should never be attempted. But today, we generally make a horizontal incision in the lower part of the uterus. This incision is the one with the least chance of tearing. Again, the time between two pregnancies is also an important factor. If there is less than 1 year between 2 pregnancies, vaginal birth should never be attempted. Again, if you have previously experienced an event such as uterine rupture or if you have had a myoma removal surgery with an incision covering all layers of the uterus, normal birth should never be attempted.
AFTER CAESAREAN. FACTORS INCREASING THE FAILURE OF VAGINAL BIRTH
*Having never had a vaginal birth before
*Time lapse, that is, labor has not started yet at the 41st week
* > 40 maternal age
*BMI (body mass index) over 30,
*Previous cesarean section; In cases where the birth is performed for a reason such as not progressing, the genital tract is not suitable or not opening, the probability of VBAC being successful decreases and it may turn into a cesarean section.
The VBAC decision is made after the individual evaluation of each expectant mother, based on the benefit-loss ratio. It is a decision that should be taken together with the doctor, taking into account the pregnancy and birth process. Therefore, such an idea If you have any, you should discuss this with your doctor at the beginning of your pregnancy and decide together according to the possibilities.
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