Choosing Vaginal Birth After Cesarean Delivery

Congratulations, you have another bundle of joy on the way and it’s time to weigh your options on a birthing plan. A question we often hear is, “If I had a C-section in the past, am I able to have a vaginal birth with my next child?” It was once believed that if a woman had a cesarean birth, she would always have a cesarean with subsequent pregnancies. This is not always the case.

Why Attempt Vaginal Delivery Now? 

There are many reasons why people choose vaginal deliveries after having a cesarean:

• Less risk. A vaginal delivery has fewer complications for the mother than a cesarean birth. A cesarean requires major surgery with anesthesia. With any operation there is a risk of infection, bleeding, transfusion, and other potential complications.
• Shorter recovery. The mother is able to return home faster after a vaginal delivery. The recovery time, both in hospital and at home, is quicker for the mother with a vaginal delivery than a cesarean. Those who deliver vaginally can usually resume normal activities sooner.
• More involvement. Some women wish to be awake and fully involved in the birthing process. Sometimes general anesthesia is used during cesarean delivery, and the mother may not be awake and cannot experience the actual birth. There also may be limitations on the presence of others in the delivery room with a cesarean birth.

Factors to Consider for Your Birth Plan

Find a Community physician and discuss each factor that needs to be considered before choosing a vaginal birth. Your physician will review prior medical records and verify which type of uterine incision was used. This will help determine whether you’re a good candidate for vaginal birth.

• The transverse incision. Made across the lower, thinner part of the uterus. This is the preferred incision type for a cesarean delivery. It heals with a stronger scar and is least likely to result in complications in a subsequent vaginal delivery.
• The lower vertical incision. An up-and-down cut made in the lower, thinner area of the uterus. The risk involved in vaginal birth after this type of uterine incision are not well defined.
• The classical (high vertical) incision. An up-and-down cut made in the upper part of the uterus. This was once the most common type of incision used in cesarean births. Unfortunately, a complete rupture, or opening, of the scar is more likely to occur during labor than other incision types. This can result in a serious bleed that poses a danger to both mother and baby.

Because of the increased risks that go with a cesarean, many women are being encouraged to consider vaginal delivery even after having a C-section. Remember, it’s still important to plan for the unexpected. Situations may arise where vaginal delivery is no longer an option, but Community Health Network is here to help with all of your pregnancy care needs. Keep an open mind and work collaboratively with your doctor to find the best plan for you.