I went through this myself a week ago. Here is the story: Natural birth after cesarean section after 1 year and 3 months. I did it!!! and it turns out there are a lot of people willing.
Z.Y. those who are categorically against EP after the CS, please either pass by or express your opinion without attacks
Myth No. 1. Doctors can give the go-ahead for EP only if many years have passed since the CS (according to various sources, up to 8).
Those who don't know say this. The doctor at the RD said nothing to me and didn’t tell me that the term was only 1 year and 3 months. Decisive factor It is not the duration, but the consistency of the scar, it is formed within a maximum of 6 months, and then does not change. Therefore, if in a year he is not wealthy, then in 5 years he will be the same.
Myth No. 2. The maternity hospital will require an extract from the institution where the CS was performed, indicating the used suture material, currents postoperative period and God knows what else.
In fact, they didn’t demand any kind of extract from me, but only verbally asked about the reasons for the previous CS and whether there were any problems later, but sometimes they ask. Make a copy of the exchange card, that's enough.
Myth No. 3. You can give birth yourself only if the scar at the time of birth is larger than 3 mm.
Yes, my scar was 3 mm. But for many it was 2.5 and even a friend gave birth with 1.8 mm. The main thing is that it is homogeneous and correctly formed.
Myth No. 4. In the case of ER after CS, early hospitalization is required for a period of 37-38 weeks.
I went to bed at 39 weeks, but just to get examined. They let me go for walks until I was 40 weeks exactly, until August 1st. She arrived on the evening of July 31 and gave birth in the PDR)
Myth No. 5. During ER after CS, stimulation is not used as a matter of principle - supposedly this can provoke uterine rupture and other complications.
In fact, I don’t know about oxytocin, but stimulation in the form of active preparation of the cervix (Halidor tablets, Buscopan suppositories, Papaverine injections, valerian) and bladder puncture are used with all their might. And they pierced me as soon as I got into the labor room, so there’s less stress.
Myth No. 6. During ER after CS, anesthesia is not used, because you can miss the threat of uterine rupture by the scar.
They actually use it. They gave me an epidural and they said if everything is fine, then it’s okay.
Myth No. 7. During EP with a scar, you must constantly lie down, because They do ultrasound and CTG all the time.
In fact, after the bladder puncture, I was strongly advised to walk around, I lay down myself, it was easier for me. But the CTG was always connected. An ultrasound was done only before childbirth.
Myth No. 8. For ER after CS, episiotomy is always used.
In fact, the doctor told me in plain text - I’d rather cut you there than do a CS. But my child was large, big-headed. At first I let her try it herself, but they realized that I couldn’t do it. So we did an episodic
Myth No. 9. After birth, the uterus is manually monitored for ruptures. general anesthesia.
In fact, some yes, some no. Under general anesthesia there was nothing like that, they injected more painkillers and looked at the uterus manually, but I was conscious and didn’t feel anything. Then they did an ultrasound. Some people only get an ultrasound.
Myth No. 10. Judging by the descriptions of maternity hospitals on the website “www.rodi.ru,” you can give birth after a CS in almost every second maternity hospital in Moscow.
In fact, it is also written on the fence. But in practice, there are only one or two such places in Moscow - and there are no more. It is better to trust not descriptions, but specific stories from specific people. For example from here or from here. There are doctors, but it’s very difficult to get in touch with them.
Myth No. 11. EP after a CS is an extremely scary and risky event.
In fact, for me personally, everything turned out to be somehow not so difficult, and quite quickly, they even delivered a rapid labor. In general, childbirth is already a risky undertaking. The same uterine rupture during childbirth occurs in women without a scar. Here it’s destined for everyone.
Absolute indications for caesarean section in women with a uterine scar .
- Scar on the uterus after corporal caesarean section(i.e. carried out in the body of the uterus, which is rare: since 1930 in our country, preference has been given to caesarean section in the lower uterine segment).
- Incompetent scar on the uterus according to clinical and echoscopic signs.
- Placenta previa in the scar (in this case, the danger lies not in uterine rupture, but in placental abruption).
- Truly narrowed or deformed pelvis.
- In Russia - two or more cesarean sections in history - as a rule, the second cesarean section is performed over the first scar. (However, in many countries this indication is not absolute; women give birth vaginally after two or even three caesarean sections).
Among relative readings for repeat cesarean - large fetus, anatomically narrow pelvis in a woman, high myopia, other extragenital diseases.
I would like to tell you about my experience natural birth(ER) after cesarean section (CS), I think there are those who would like to know a little more about this process.
If I tell you briefly about my first pregnancy, it went well for me, the birth was supposed to be natural, but at 39 weeks my placental abruption began, bleeding began and I urgently The operation was performed under general anesthesia.
Words cannot express the feelings of despair and helplessness that I experienced when I found out that the CS operation was inevitable, because it was like thunder among clear skies. I was so mentally depressed that it all seemed terrible and wrong. Now, of course, I understand that there was no other way out, and the main thing is that my healthy child was born.
Apparently, after giving birth my emotional condition was not very stable, thanks to my family for their support, for the moral and physical help they provided. My mother-in-law looked after me and my grandson for all 40 days. But at that moment I decided that my next birth would be natural.
There are many factors that influence ER after a CS, we will focus on them point by point:
- At least 3 years must pass between the first and second pregnancy (in my case, I gave birth when my son was exactly 3 years old, which means I became pregnant after 2 years and 3 months);
- The operation was carried out on relative rather than absolute terms;
- The postoperative period was calm, without complications;
- The child after the CS is absolutely healthy;
- There is only one scar on the uterus, in the lower uterine segment and only after a CS, and not, for example, after a myomectomy (removal of uterine fibroids);
- The second pregnancy proceeded without complications;
- According to ultrasound, the placenta is located in the scar area;
- There are no thickenings, or vice versa, thinning of the wall of the lower uterine segment;
- The weight of the child during full-term pregnancy does not exceed 3800-3900 g;
- The scar is uniform along its entire length and its thickness is 3-6 mm (according to ultrasound), the scar should not hurt;
- There were no miscarriages or abortions after the CS.
Of course, all these indicators are individual, but they are basic.
An important role is played by your decisive attitude, which neither doctors, nor obstetricians, nor ultrasound specialists can bring down.
By the way, in my case, it was the ultrasound doctor who betrayed my self-confidence, which cannot be said about the doctor who was supposed to deliver the baby.
As you understand, the amount was also discussed with the doctor, since I was afraid that if I didn’t pay, I would be sent for surgery.
So, the doctor reminded me at every opportunity that if something went wrong, they would cut me off.
And when I went to check the consistency of the suture on the uterus (it is checked at 38-39 weeks), the ultrasound doctor recommended that I try to give birth myself, since the indicators were good ( good timing between births, age, consistency of the suture 3-4 cm around the entire perimeter), besides, the cervix was already ready, and why not take the risk, they will always have time to do a CS.
Always be decisive, analyze all the pros and cons, do not be afraid to contradict the doctor and ask what, how and why. If you are confident in yourself, in your health and in the health of your child, you will be able to give birth on your own even after a CS.
Now I know this for sure, and I wish you good luck.
P.S. I gave birth in the PDR, my water broke at 00:00, at 04:30 in the morning I gave birth to my baby.
Maria Sokolova
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Having experienced the pros and cons of a cesarean section, many women wonder whether childbirth after a cesarean is possible, and what kind? According to doctors, there can be no definite answer.
We tried to imagine All medical aspects second birth after cesarean section.
How to prepare for ER after caesarean section?
- Doctors emphasize that if the cause of cesarean section is excluded, natural childbirth is safer rather than a second caesarean section. Moreover, for both mother and baby.
- Doctors advise maintain proper spacing between births – at least 3 years, and avoid abortions, because they have a bad effect on the uterine scar.
- It is better to make sure that the scar is in normal condition, visiting a doctor when planning a second birth after caesarean section. If necessary, the doctor may prescribe hysteroscopy or hysterography. These studies can be carried out a year after the operation, because that is when the formation of the scar is completed.
- If you did not have time to examine the scar before pregnancy, now this can be done using vaginal ultrasound over 34 weeks . Then it will be more correct to talk about the reality of natural childbirth after cesarean section.
- Natural childbirth is unacceptable if the previous cesarean section was performed with a longitudinal scar . If the seam was transverse, then independent childbirth after cesarean section are possible.
- An important aspect of independent childbirth after cesarean is no postoperative complications , the singularity of the operation, as well as the place where it was carried out - lower segment uterus
- In addition to the above requirements, for natural childbirth after cesarean the course of pregnancy is essential , i.e. absence of multiple pregnancies, full term, normal weight (no more than 3.5 kg), longitudinal position, cephalic presentation, attachment of the placenta outside the scar.
Benefits of self-birth
- Absence abdominal surgery , which is essentially a caesarean section. But this includes the risk of infection, possible damage to neighboring organs, and blood loss. And extra anesthesia is far from useful.
- Obvious benefits for the child, since it goes through a period of adaptation more smoothly, during which all its systems are prepared for new conditions. Moreover, passing through birth canal the baby is freed from the amniotic fluid that has entered inside. Disruption of this process can cause pneumonia or asphyxia.
- More easy recovery after childbirth, especially due to refusal of anesthesia.
- Opportunity physical activity , which makes caring for the baby and postpartum depression easier.
- No scar on the lower abdomen.
- No post-anesthesia conditions: dizziness, general weakness and nausea.
- Pain goes away faster V postpartum period and, accordingly, the hospital stay does not extend.
Disadvantages of EP - what risks exist?
- Uterine rupture However, statistics show that primiparous women without a scar on the uterus also have the same risk.
- Mild urinary incontinence is acceptable for several months after birth.
- Significant vaginal pain, but they go away faster than the pain after a cesarean section.
- Increased risk of future uterine prolapse. Special gymnastics for the pelvic muscles help prevent this.
Assessing the chances of spontaneous childbirth after cesarean
- In 77% of cases, childbirth will be successful if there was a cesarean section in the past, and more than one.
- In 89% of cases they will be successful if there has been at least one vaginal birth before.
- Induction of labor reduces the feasibility of simple labor because prostaglandins increase the load on the uterus and its scar.
- If this is 2 births after a cesarean section, then the possibility of an easy birth is slightly less than if you have already had one natural birth.
- It is not very good if the previous surgical intervention was associated with the newborn getting “stuck” in the birth canal.
- Excess weight can also have a detrimental effect on the second birth after the first cesarean section.
Hello Nika! If you used emergency contraception to prevent pregnancy, that is, took Postinor, then a delay in menstruation occurs quite often. It happens that minor bloody issues soon after taking the drug, and the onset of regular menstruation is delayed. Sometimes such delays are 14 days or more. In your case, as you write, the delay has been going on for about three months. And I am very surprised by your carelessness and the fact that you, apparently, still have not gone to the doctor. Postinor taken according to the regimen is a fairly reliable means of contraception, but to exclude pregnancy it is better not to trust the tests, but to get tested at an antenatal clinic.
Emergency contraception methods are very effective and are most effective when taken immediately after sex. However, they are less effective than permanent use another method of contraception. Also, this drug will not protect you from sexually transmitted infections (STIs), including HIV.
Of all the pregnancies that statistically can result from one episode of unprotected sex, emergency contraception will prevent:
* Up to 95% of pregnancies if taken within the first 24 hours.
* Up to 85% of pregnancies if taken within 25 to 48 hours.
* Up to 58% of pregnancies if taken between 49 and 72 hours.
In theory, emergency contraception can prevent pregnancy if taken after 72 hours, but its effectiveness is unknown.
Women must firmly understand that taking the drug "Postinor" is an emergency contraception measure. And it is not recommended to take this medicine more than once a year. Since even a one-time dose can cause hormonal imbalance in the body. I don’t know how you took the emergency contraceptive pill and therefore, we can assume that such a long delay in menstruation may well not be due to hormonal imbalance, namely with pregnancy.
If your period is late while taking contraception, do not delay visiting your doctor, even if you are 100% sure that you are not pregnant. The absence of menstruation may indicate diseases of the female reproductive system. I repeat once again, go to the doctor and under no circumstances take any independent steps to induce menstruation! Let a specialist look at everything himself and assess your condition. After this, at least it will be more clear what to do next. Good luck!
Hello!
Good luck!
Hello!
It is impossible to answer your question unambiguously without even knowing the character menstrual cycle, its regularity. In any case, you will have to make the decision yourself.
There is an opinion that a woman’s menstrual cycle can be divided into 3 phases:
Relative sterility (conception is unlikely) - lasts from the first day of menstruation until ovulation.
Fertility (the most favorable phase for conception) - from the moment of ovulation and ends 48 hours after it.
Absolute sterility - begins 48 hours after ovulation and before the start of the next menstruation.
It is even based on this position calendar method protection against unwanted pregnancy, the essence of which is abstaining from unprotected sexual intercourse during the fertile period.
However, such a method can be considered ineffective and rather arbitrary; I would say that there are no absolutely safe days during the cycle. If you know exactly the time of ovulation, the days before the start of your next menstruation can be considered relatively safe.
It is believed that ovulation occurs approximately in the middle of the cycle (usually on days 11, 12, 13 or 14 of a 28-day cycle). However, with a 28-day cycle, ovulation is possible between the 8th and 20th days.
It depends on the individual characteristics female body and many external and internal factors, affecting the very fragile and dependent hormonal background of a woman.
And even if monthly cycle If you have a regular cycle, you cannot be sure that ovulation in a given cycle will occur in the middle of the cycle, and not earlier. Accordingly, if the cycle is short, ovulation can occur on days 8-10 of the cycle. And given the fact that the lifespan of sperm in a woman’s body can reach 10 or even more days, it is impossible to exclude the possibility of conception from sexual intercourse during menstruation.
On the other hand, the use of emergency contraception is extremely undesirable, since it causes a significant blow to the woman’s hormonal system, as a result of which various unpleasant consequences, from menstrual irregularities to uterine bleeding, and other side effects.
Thus, you need to evaluate what is scarier for you - unwanted pregnancy or possible problems with health. Take into account your state of health, the stability of the menstrual cycle, age and social factors. If you are young, not financially independent, and fairly confident in your health, it is better not to risk it and take a postcoital contraceptive, because hormonal pill still better than a possible abortion.
I wish you good luck and good health!
