More recently, in obstetrics, the rule was adopted: “One caesarean-always caesarean”, that is, it was believed that natural childbirth with a scar on the uterus is impossible, since during labor or attempts there is a risk of divergence of the scar and rupture of the uterus. Now this rule has become irrelevant, and the presence of a scar on the uterus itself is not a 100% indication for surgery. All over the world, natural childbirth after cesarean section has become practiced, and they are successfully carried out in our country. Of course, such childbirth is not possible in all cases, but only when there are no contraindications to them. What can prevent a natural birth after a caesarean section? First of all, these are some medical features of the state of health of the mother and child.
Indications for repeated caesarean section:
- inferiority of the scar on the uterus;
- longitudinal scar;
- placenta previa;
- anatomically narrow pelvis and pelvic deformities;
- transverse or pelvic presentation of the child;
- placental presentation;
- large baby (more than 3800 g);
- retinal pathology;
- severe diseases of the expectant mother (for example, diseases of the cardiovascular system; diabetes mellitus);
- multiple pregnancy.
It is clear that if the cause of the previous caesarean was an anatomically narrow pelvis, then the operation cannot be avoided in the next pregnancy.
But if the reason for the operative delivery was precisely in the features of the previous pregnancy (for example, there was a placenta previa or breech presentation), and in this pregnancy there is nothing like this, it usually proceeds, the mother and child feel good, then childbirth naturally is quite feasible.
How to prepare for pregnancy and childbirth after cesarean section
Regardless of how a woman will give birth after the first C-section (naturally or with the help of a second surgery), you need to prepare for the second pregnancy and childbirth. First of all, you need to get an extract from the hospital after the previous birth and see some points in it:
- the reasons for which the caesarean section was performed;
- the cesarean section procedure;
- method of suturing the incision on the uterus;
- suture material used during the operation;
- during the postoperative period;
- complications during and shortly after surgery;
- volume of blood loss;
- treatment that was performed after the operation.
These data are very important when planning the next pregnancy and choosing the method of delivery, says Reyus Mammadli from IYTHealth.com.
Even before planning a pregnancy, you need to visit a gynecologist, do an ultrasound of the pelvic organs and determine the readiness of the uterus and postoperative scar for carrying and giving birth to a baby. It is also advisable to observe some rules.
It is believed that the next pregnancy after cesarean section should occur no earlier than two or three years after the operation, since it is during this time that the muscle tissue in the area of the scar on the uterus is restored.
When pregnancy occurs, it is necessary to regularly do an ultrasound, during which the doctor will additionally examine the condition of the scar. It is best to undergo examinations in a modern maternity hospital, where doctors have experience in managing pregnancy and childbirth with a scar on the uterus.
Usually, how a woman with a scar on the uterus can give birth after a cesarean section will become clear towards the end of pregnancy – after the condition of the scar, as well as the mother and child, is finally determined.
Natural childbirth: More details
Natural childbirth after cesarean section, as well as in the usual case, consists of three periods: first there are contractions, then attempts and all ends with the birth of the placenta. But there are also some features. First, the woman in labor and the child will be monitored more closely than in normal childbirth (for example, CTG will be performed more often or even constantly). Stimulation of labor with the weakening of labor activity will not be carried out (to avoid the risk of rupture of the uterus along the scar). Most likely, the pain relief of childbirth will also not be done (so as not to miss the pain when the scar is threatened to diverge). After the birth of the placenta, the doctor examines the uterine cavity and checks the condition of the scar, according to iythealth.com.
Repeated C-Section – What to Expect
If a woman gives birth again by planned caesarean section, then, as with the first operation, she will be assigned a date of delivery in advance, perhaps she will be recommended to go to the hospital the day before in order to prepare for the operation. As a rule, the technique of performing a second operation will not differ from the first, although sometimes the operation itself can be more complicated and will be carried out longer (for example, due to the fact that after a caesarean section (as after any cavity operation), an adhesive process is often detected).