Pregnancy normally ends with natural birth, but in obstetric practice there are many cases when it is necessary to resort to caesarean section. This abdominal surgery, during which an incision is made in the uterus and the baby is removed. The reproductive organ retains its functions, and the woman can become a mother again. How long before you can get pregnant after a cesarean section and is there any hope that next birth will they be natural?
What happens in the female body after a caesarean section?
Modern execution techniques caesarean section and postoperative therapy minimize the risk of complications - adhesions, uterine subinvolution, endomyometritis.
After the anesthesia wears off, a woman may have the following problems:
- pain in the area of the incision;
- difficulties with urination, bowel movements;
- nausea, vomiting, weakness;
- dizziness, hallucinations as consequences of anesthesia;
- swelling, sweating.
To avoid adhesions, it is recommended to get up immediately after recovering from anesthesia (4–5 hours after surgery). Will help you get up medical staff, doctors will also monitor the condition of the woman in labor. You can walk a little, as long as the doctor allows. The baby should be fed while lying down in a comfortable position.
During the five postoperative days, a course of antibiotic therapy is carried out, the condition of the suture and the contractile activity of the uterus are monitored. The wound in the incision area will bother you with any movements or attempts to get out of bed, so painkillers are often prescribed.
In addition, doctors monitor the process of intestinal function and Bladder, monitor body temperature. Its increase may be a natural reaction to surgery. However, it is important for doctors to make sure that during the operation no infection was allowed to enter the abdominal cavity.
On days 5–7, the woman is examined, the sutures are removed, and control tests are done. If the condition is satisfactory, she and the baby are discharged home. At the same time, they give recommendations on diet and nutrition, and advise limiting physical activity, heavy lifting and sexual intercourse for 2 months. If hemoglobin levels are low, iron supplements are prescribed.
At home, it is important for a woman to monitor her well-being and observe the nature of vaginal discharge. Don't worry if the seam looks ugly: after 1-2 years it will lighten and become almost invisible. If a keloid scar forms, laser surgery or resurfacing may help in the future.
In addition to physical problems, a woman may be bothered by a feeling of guilt that she was unable to give birth on her own. Don't delve into negative experiences. IN modern world many children are born by caesarean section. This saves them and their mothers from severe postpartum complications, serious injuries.
What long-term consequences of a cesarean section can interfere with natural childbirth?
Caesarean section does not always pass without leaving a trace women's health. One of its consequences is adhesions (adhesions of connective tissue between internal organs and intestinal loops). They are the cause of secondary infertility, ectopic pregnancy. When planning your next conception, it is important to make sure that they are absent. If a pathology is detected, do not despair: adhesions can be successfully treated with physiotherapy and eliminated surgically.
Unlike independent childbirth, after a cesarean section a scar remains on the uterus. It can interfere with the attachment of a fertilized egg and poses a threat of rupture of the reproductive organ during contractions and attempts when trying to give birth next time naturally.
After surgery, a full scar is not always formed, especially if the incision is made vertically. When an incompetent scar forms, the tissue in the suture area is formed incorrectly. There are cavities, unfused areas, and a large amount of connective tissue. This will prevent the uterus from stretching during a subsequent pregnancy and will jeopardize pregnancy.
Postoperative hernia is another obstacle to natural childbirth. It can cause problems with work digestive system, spine, provoke prolapse of the vagina and uterus. Hernia subject surgical treatment. Only after this can the question of a new conception and independent childbirth be raised.
Is it possible to give birth on your own with a history of CS?
Is it possible to give birth on your own after a caesarean section? A second pregnancy is planned no earlier than 3 years after the operation. To avoid accidental conception, you should choose the optimal means of contraception. If this happens, the medical council will raise the question of medical abortion. A woman’s chances of carrying and giving birth to a child immediately after surgery are 1 in 10. The entire pregnancy will have to be carried out under strict medical supervision, with the last months being the most dangerous.
After three years, a full-fledged, elastic and well-extensible scar is formed on the uterus. From now on, you can plan to conceive and natural childbirth after cesarean. The optimal time for the next pregnancy is 3–5 years after a cesarean section; in 60% of cases it ends in spontaneous childbirth. After 5 years, the scar may lose its elasticity, which will cause miscarriage.
Women who have had a horizontal incision are more likely to have a vaginal birth. When choosing a method of delivery during a subsequent pregnancy, doctors take into account the age of the woman in labor, the pathology of pregnancy, the size and condition of the scar and sutures. They assess the risks to the mother and fetus. It happens that tactics have to be changed on the fly. If problems arise during spontaneous childbirth, surgical intervention is resorted to.
In what cases is surgical delivery necessary?
- if without surgery the death of the woman in labor and the fetus in the womb may occur;
- when natural childbirth is fraught with serious consequences.
In the CIS, there are protocols that clearly define the indications for abdominal surgery. They refer to situations where there is a risk to the mother or fetus. Conventionally, indications are divided into absolute and relative. They occur during pregnancy or on the eve of childbirth.
Absolute indications are not negotiable. The obstetrician sets the time for the operation and explains to the expectant mother why he chose this method of delivery. Ignoring the doctor’s opinion can lead to serious consequences for the woman and child, including their death.
Relative indications relate to cases where natural childbirth is possible, but there is a high risk of birth trauma, fetal disability, postpartum hemorrhage. These cases are reviewed by a council of doctors. They weigh the consequences of cesarean section and spontaneous childbirth, convey information to expectant mother.
Absolute readings
Situations when it is impossible to give birth without a caesarean section:
- placenta previa;
- premature detachment of the child's place;
- threat of rupture of the reproductive organ;
- number of scars on the uterus – 2 or more;
- anatomical narrowing of the pelvic bones of 3–4 degrees;
- tumors, deformations of the pelvic bones;
- irregular scar on the reproductive organ;
- multiple fibroids;
- malformations of the vagina, uterus;
- severe heart disease;
- gestosis;
- sutures after plastic surgery on the vagina;
- oblique or transverse presentation of the child;
- history of third degree perineal rupture;
- first birth at 30 years of age or older in combination with other threatening pathologies;
- death of the mother (the fetus remains alive in the womb for several more hours).
Relative readings
There are situations when, when choosing a method of delivery, the doctor takes into account the opinion of the expectant mother. In 80% of cases, women unconditionally agree to a caesarean section. Circumstances under which it is dangerous to give birth yourself include:
- clinically narrow pelvis;
- severe separation of the pubic bones;
- pregnancy after IVF with complications, a history of abortion, miscarriage;
- post-term pregnancy in combination with pathologies;
- varicose veins of the vagina;
- oncological diseases;
- fetal hypoxia;
- child weight more than 4 kg, multiple births.
Umbilical cord entanglement is not considered an indication for which a caesarean section can be forced. However, doctors do not exclude the possibility that they will have to resort to surgery; they take into account the type of entanglement (tight, non-tight, single, multiple).
Can they force me to give birth on my own or, conversely, agree to undergo surgery?
If the obstetrician insists on performing abdominal surgery after one or two caesarean sections, the woman should not refuse. The specialist’s experience allows us to predict how a natural birth will proceed after a previous cesarean section and what complications are possible. You should not lead to a situation where you need to resort to a CS urgently. This is possible in the following cases:
- absence labor activity(the cervix dilates slowly after 16 hours from the start of contractions);
- fetal hypoxia during labor (detected using CTG);
- umbilical cord prolapse.
There are states in which women themselves choose how to give birth. For example, this is what happens in the UK. In Russia, this practice is not used. There are no laws that prohibit surgical delivery without obvious indications.
A history of caesarean section is relative indication to repeat CS. A woman in labor may be offered to give birth herself after a cesarean section, which she has the right to refuse in writing, citing medical history. If you are forced to give birth yourself, you can resort to contract childbirth and choose operative delivery in advance.
Since a CS is a serious abdominal operation, the desire of the expectant mother alone is not enough to carry it out. If there are no serious indications, best way out– natural birth after caesarean section. They usually last longer and are managed carefully, trying not to resort to pain relief. After birth, intravenous anesthesia is administered and a manual examination of the uterus is performed and the condition of the scar is assessed.
Over the past 15 years, the situation in obstetrics has changed. Both doctors and patients suddenly remembered our great-grandmothers, endless Russian fields and numerous haystacks. In the 21st century, we have finally come to the conclusion that childbirth is a natural process, and it is necessary to intervene only in case of a threat to the health of the woman or child
However, one in four women gives birth by caesarean section.
Main indications for caesarean section
- incompetent scar on the uterus, two or more scars;
- complete placenta previa or incomplete with bleeding;
- accompanying illnesses of cardio-vascular system, severe myopia, diabetes;
- multiple pregnancy (usually triplets);
- pelvic or transverse presentation of the fetus in combination with the expected large weight;
- multiple uterine fibroids, cervical diseases;
- anatomically narrow pelvis.
As you can see, scars on the uterus are the main indication for cesarean section. It is easy to see that the circle has closed. Until recently, most women who had a caesarean section had no choice in their second birth. The focus of modern obstetrics on natural childbirth has changed the situation.
Statistics have been published that partially explain the popularity of cesarean sections. Thus, in America, in the state of Washington alone, about 11,000 unnecessary operations are performed per year. This is because clinics receive high insurance premiums for these services. State authorities were even forced to adopt a legislative amendment to avoid such a development.
The chances of a successful natural birth in a primiparous healthy woman are very high - up to 90%, and in a patient who has undergone one cesarean section - up to 76%. There is evidence that even after two abdominal births, the probability of successful natural births is 71.1%
After a cesarean section, a scar forms on the uterus within one year. A complete scar consists of muscle tissue, which is capable of stretching as the uterus grows and contracting during contractions. Natural childbirth in this case raises almost no concerns.
A defective scar is formed from connective tissue that may not withstand stretching during natural childbirth. Proven incompetent scar – absolute contraindication to vaginal birth. The most dangerous complication in natural childbirth in women with a scar on the uterus - uterine rupture. Its probability is 0.05-0.1%, and the mortality rate is 12-18%. The death of a child due to uterine rupture occurs in 1% of cases. All these numbers speak of the responsibility with which one must approach the tactics of managing childbirth with a uterine scar.
Preparing for natural childbirth
After a caesarean section, you need to prepare for the second birth in advance.
The minimum interval between births is 2 years. Obstetricians strongly recommend using reliable methods of contraception. Abortion after cesarean section is extremely undesirable - the procedure thins the muscular wall of the uterus, and this can lead to scar deformation. It must be said that abortions are generally extremely undesirable.
Before planning a pregnancy, you need to check the condition of the scar. To do this, it is necessary to do an ultrasound, but with the help of this diagnostic method it may be impossible to establish the complete picture. The most accurate data is provided by:
- hysterography – x-ray of the uterus after administration of a contrast agent;
- hysteroscopy - examination of the uterine cavity using an endoscope - a miniature camera - inserted into it.
It is better to assess the condition of the scar 8-10 months after surgery. Only after these studies does the obstetrician-gynecologist answer the patient’s question whether she can give birth on her own after a cesarean section.
Features of pregnancy with a uterine scar
Pregnancy with a uterine scar proceeds almost the same as without it. In natural childbirth after cesarean section, stimulation is undesirable - a sharply increasing strength and frequency of contractions can threaten the viability of the scar.
C-section - operative method delivery, in which abdominal surgery is performed to remove a child from the mother’s womb if he cannot be born naturally. After the operation, a scar remains on the uterus, and a suture remains on the abdomen. Many women believe that after a cesarean section they will no longer be able to give birth on their own. Is this true or not?
Is childbirth possible naturally?
Repeated pregnancy after cesarean is possible, just like natural childbirth.. A woman who registers is constantly monitored, and doctors take into account the course of the pregnancy and her overall condition in order to make a decision regarding the method of delivery. But what should you expect if the operation was done more than once, do women give birth naturally afterwards?
After the first operation
Caesarean section is not a contraindication to further natural childbirth. However, there are some restrictions that impede not so much the natural birth process as pregnancy in general.
The point is that after surgical intervention a scar forms on the uterus, and the tissue around it becomes thinner. If pregnancy occurs immediately after a cesarean section, there is a chance that the scar will rip apart. In addition, this can also happen during childbirth when the stretched muscles of the uterus contract. That is why it is possible to become pregnant after a cesarean section after a certain period of time.
During this period, a woman must use protection, since abortions are also undesirable at this time. Doctors recommend waiting 2.5-3 years: during this period, the muscle tissue is completely restored, and the scar is considered healthy (well healed).
But you can’t wait too long either. If pregnancy occurs 5 or more years after cesarean section, the suture on the uterus may come apart due to excessive rigidity, i.e. the tissue around the scar is inelastic.
It is possible and even necessary to give birth naturally after cesarean: probability favorable outcome reaches 70%. Doctors often insist that a woman give birth herself because she will be able to recover faster, and it is also better and safer for both her and the baby.
If there were 2 CS
Find out whether a woman can give birth naturally if she has already had two surgeries. If the second birth was carried out by caesarean section, the likelihood that the third birth will be natural is very small. Two scars are a serious obstacle to the natural birth process, since the risk of divergence of one of them is quite high.
Repeated pregnancy after a second cesarean section is possible no earlier than after 2-3 years.
Other risks include:
- fetal hypoxia;
- uterine rupture;
- adhesions internal organs(intestines, fallopian tubes, ovaries);
- postoperative hernia.
Usually, a doctor can tell already during pregnancy whether a woman will be able to give birth on her own, but in most cases you can’t count on a natural birth. In addition, sometimes after two caesarean sections, doctors recommend tying the tubes, i.e. insist on sterilization. After two surgical births, it is very often not possible to carry the baby to term.
Why not after the third time?
After three surgical deliveries, natural childbirth is prohibited. Moreover, the third operation in a row is itself a relative contraindication for subsequent pregnancy, and there are several reasons for this:
- adhesions from the first operations increase the risk of injury to the intestines or bladder;
- There is a risk of true placenta accreta, which requires removal of the uterus without appendages.
If a woman has had three caesarean sections, it means that there are already three scars on the uterus. Each of them poses a risk to a subsequent pregnancy, because the stretching of the uterus puts all three to a severe test. If fertilization occurs, the woman is closely monitored. At week 36, hospitalization is usually indicated.
How can you influence the process of childbirth?
However, despite the risks, many women are committed to natural childbirth, but what needs to be done to ensure that the process goes smoothly. First of all, you should consult a gynecologist 2-2.5 years after a cesarean section to undergo examinations and determine the condition of the uterine scar. 2 methods are used for diagnosis:
- hysterography(X-ray examination);
- hysteroscopy(examination using an endoscope).
Pregnancy is allowed if the scar is formed by muscle tissue and not connective tissue.
The expectant mother is prescribed other examinations and, possibly, some medical supplies, including hormonal ones. It will be necessary to eliminate all risk factors (infectious and inflammatory diseases), adjust your lifestyle and start conceiving.
If fertilization has occurred, the woman needs to constantly go to the doctor. Throughout pregnancy, the condition of the scar is monitored, especially in the last trimester. Usually by the 35th week it becomes clear whether a woman can give birth on her own or not. However, it is possible that if natural delivery is permissible, problems will arise (for example, weak labor), and then you will have to resort to an emergency caesarean section.
At approximately 36-37 weeks, the woman in labor is hospitalized so that her condition can be monitored and, if necessary, prepare for surgical delivery.
Suspected complications
Preparation for childbirth and the birth itself after cesarean are almost the same as any other birth. However, women should not push ahead of time; it is forbidden to use anesthesia and drugs that stimulate labor.
Statistics show that complications during natural childbirth after cesarean section occur with approximately the same frequency as during surgical delivery.
Possible complications:
- scar rupture;
- fetal hypoxia;
- perineal rupture;
- heavy bleeding;
- deterioration contractility uterus during childbirth;
- uterine prolapse;
- birth injuries.
Contraindications
After a caesarean section, the woman receives a discharge from medical card, which describes in detail why the decision was made to undergo surgical delivery.
This is done in order to make a prediction in advance whether the woman will be able to give birth herself. This is usually possible if the factor preventing spontaneous childbirth has been eliminated.
Contraindications to natural childbirth after cesarean are::
- failure of the scar (less than 2 years have passed since the operation or the scar has not healed due to slow tissue regeneration);
- the presence of a longitudinal scar on the uterus;
- the presence of 2 or more scars on the uterus;
- location of the placenta in the scar area;
- narrow pelvis;
- discrepancy of the pubic bones;
- multiple pregnancy;
- deformation of the pelvic bones;
- large fruit;
- fetal development abnormalities;
- threat of hypoxia;
- long gap between births (more than 5 years);
- tumor formations in the pelvic organs;
- breech or transverse presentation of the fetus;
- risk of retinal detachment;
- diseases of the cardiovascular and nervous system;
- weak labor activity.
In all other cases, natural childbirth after cesarean section is possible.
Experts' opinions
Experts are inclined to believe that, If a woman has no contraindications, she should give birth herself. However, it is not only physiological factor, but also psychological. Sometimes it is difficult for a woman in labor to mentally prepare for a natural birth, because there were problems with this for the first time. Fear and uncertainty can hinder the birth process, so in this case it is better to agree to a repeat operation.
Another important point: Obstetrician-gynecologists do not recommend resorting to anesthesia during natural childbirth. Epidural anesthesia may slow down birth process, weaken labor and even negatively affect the baby.
If a woman is at an age favorable for giving birth to children (up to 35 years), the pregnancy proceeded well, the suture consists of dense muscle tissue, the uterus has not lost elasticity, the fetus has normal size and labor begins on time, there is every chance of a favorable natural birth.
Risk factors are:
- large fruit;
- mother's age is more than 35-40 years;
- the presence of two or more scars on the uterus;
- premature contractions (before the 38th week).
In these cases, it is better to agree to a repeat cesarean section.
Mothers who find themselves in a situation of repeat pregnancy after a cesarean section are recommended to listen to the advice of the doctor and their inner voice: usually a mother’s instinct tells her what to do best.
A repeat cesarean section frightens many people because a third pregnancy is unlikely. In this case, women agree to have a natural birth at their own peril and risk, and faith in the best and concern for your own child allow you to successfully give birth to a baby on your own.
The psychological factor (fear of repeated surgery or natural childbirth) in most cases disappears when it comes to the health and life of an unborn child.
Caesarean section is used in only 20-25% of births, and, as a rule, does not interfere with the subsequent appearance of children naturally. A woman should take care of herself and avoid nervous overstrain and lead healthy image life, follow all doctor’s recommendations and plan pregnancy no earlier than 2 years after surgical delivery.
Useful video
We invite you to watch a video about the possibility of spontaneous childbirth after a caesarean section:
Caesarean section should be performed only in cases where natural childbirth is associated with a high risk to the health and life of the fetus or mother. However, in Lately quantity planned operations has become more frequent. Some time passes, and many women who want to once again experience the happiness of motherhood begin to wonder whether natural childbirth is possible after a cesarean section.
Doctors do not give a clear answer to this question. The second and subsequent births can take place either vaginally or through repeated surgery. Let's consider when a second birth after a cesarean section is allowed, under what conditions a repeat operation is required, and how high the risks of natural childbirth are after several years after a cesarean section.
What you need to know about caesarean section
Despite the fact that, according to statistics, the number of children born as a result of surgery is steadily growing, many women have little knowledge of the indications for surgery and what risks and complications it causes. The first caesarean section is performed solely for medical reasons. A pregnant woman's desire alone is not enough.
The following indications are distinguished:
- the presence of severe chronic diseases (diabetes mellitus, hypertension, cardiovascular pathologies, endocrine diseases);
- malposition;
- multiple pregnancy;
- weakness of labor;
- in severe form;
- premature placental abruption, high risk fetal hypoxia;
- various genital infections;
- anatomical defects of the uterus and other genital organs.
During a caesarean section, the baby is removed through a cut in the anterior wall of the uterus. In this case, not only an external scar remains on the skin, but also an internal one, on the uterus. It is the presence of a scar that can become an obstacle to further pregnancy and delivery naturally.
Healing of the external scar occurs in a fairly short terms, approximately a week or two after surgery. As for restoring the integrity of the uterine tissue, it takes much more time. Complete healing should take from six months to a year.
Most often it is carried out as planned, but a decision may be made to emergency implementation with the threat of uterine rupture, sudden cessation of contractions, early placental abruption.
Two types of incision are possible: classic (longitudinal) and transverse (incision along the bikini line). The second type of access is more preferable because it is less noticeable and allows for the possibility of giving birth on your own in the future.
Planning for subsequent pregnancies
The most important question in this situation remains: how long after a caesarean section can you give birth. Regardless of whether a woman plans a natural birth or through a repeat operation, the period between childbirth and the next conception should not be less than two years. Such time frames are completely justified: during this time, the uterine scar should heal completely and the integrity of the organ tissue should be restored.
Pregnancy occurring one year after a cesarean section is associated with a very high probability of scar softening. During contractions, the scar may rupture and, accordingly, the death of the child, and sometimes the death of the mother.
In the two to three year period between pregnancies, a woman must approach the issue of contraception very responsibly. Your doctor will help you choose the most optimal means of contraception. The use allows not only to avoid premature pregnancy, but also to restore hormonal levels.
Carrying out abortions at this time is also highly undesirable. Such an intervention always has a negative effect on the condition of the uterus, especially if there is a postoperative scar on it.
When planning a pregnancy 2 years after cesarean section, the patient should consult a doctor to assess the condition of the uterine scar. The following diagnostic methods are used for this:
- Hysterography is an examination of the organ cavity using a special X-ray contrast agent introduced.
- Hysteroscopy is the study of the condition of scar tissue using an endoscope.
If the scar is practically invisible, this allows us to talk about its complete healing and maximum restoration of the body. It is considered wealthy if muscle tissue predominates. In this case, the woman may be allowed to plan a new pregnancy. If the scar forms connective tissue, a new pregnancy is contraindicated.
When is self-delivery possible?
As already mentioned, the most optimal period is 2 years after the operation. However, the principle “the later the better” does not work in this situation either. If the period between births is significant, and the second pregnancy occurs after 10 years, natural delivery is unlikely to be acceptable. Considering the mother’s advanced age at that time, a repeat operation will most likely be required.
After the operation, the woman must take an extract from the labor history, which will indicate the reasons for the surgical delivery, the method of suturing the incision, and suture material, other features of the operation. In the future, these indications will be taken into account when deciding on the possibility of vaginal birth.
Spontaneous childbirth after cesarean section is possible in the following cases:
- Availability cross section uterus;
- the previous operation was performed for indications related to the characteristics of the first pregnancy (for example, multiple births, abnormal fetal position, premature placental abruption);
- restorative postoperative period passed without complications;
- the course of a new pregnancy without severe pathologies;
- satisfactory condition of the uterine scar;
- cephalic presentation of the fetus;
- lack of attachment of the placenta in the area of scar tissue;
- the child's weight is no more than 3.8 kg;
- psychological readiness of the mother for natural childbirth.
Be sure to take into account the consistency of the scar. It is considered as such if its thickness is at least 3 mm.
Repeated spontaneous childbirth has a number of benefits for both mother and baby. They increase the possibility of natural childbirth in the future, allow a woman to return to normal much faster and, do not cause difficulties with breastfeeding, contribute to a faster adaptation of the baby to the outside world.
When self-delivery is not desirable
- In the presence of a narrow pelvis, chronic severe pathologies, increased risk of hypoxia and fetal death. The suture material that was used during the previous operation is taken into account. A positive aspect is the use of modern synthetic materials(vicryl, polyamide).
- If the recovery process was difficult, with an increase in body temperature, development inflammatory process and prolonged contraction of the uterus.
How possible is spontaneous childbirth after 2 caesarean sections?
Doctors usually note that this is unlikely. In this case, the risk of developing various complications is very high, including:
- oxygen starvation fetus;
- rupture of the uterine body;
- further development of the adhesive process in fallopian tubes or ovaries;
- the appearance of a postoperative hernia.
If several decades ago women were prohibited from becoming pregnant after two caesarean sections, today such restrictions no longer exist, but it is unlikely that it will be possible to avoid surgery for the third and further births. Each subsequent operation significantly increases the risk of complications.
Preparing for childbirth
When planning a second and further pregnancies, the patient mandatory passes, allowing you to determine the condition of the scar and readiness for conception and gestation. It is necessary to treat diseases that may become an obstacle to independent delivery.
A new pregnancy after surgery proceeds without deviations from the norm. A third of pregnant women may be at risk of miscarriage due to thinning of the uterine walls. Regular examination of the uterine scar is necessary, especially during the last weeks before the expected birth. The final decision on the mother’s readiness for normal childbirth is made by the doctor no earlier than the 35th week of gestation.
Hospitalization usually occurs at 37-38 weeks of gestation. There is no consensus regarding the method of initiating labor. As a rule, they are induced artificially during the daytime, so that in case increased risk still undergo emergency surgery.
But this practice has many opponents. In their opinion, any external or artificial interference can only cause harm. Natural course of childbirth without artificial stimulation Their onset usually takes longer, but is safe for mother and baby. The best solution in this situation is individual approach for each specific case.
Course of labor
According to statistics, only a third of women decide to have another birth without surgery. This is due to fear of complications and unwillingness to risk the child’s health. Meanwhile, in the absence of negative indications, the second birth after a cesarean section, taken by an experienced gynecologist, is successful.
Upon acceptance final decision pay attention to how the previous birth period, timely discharge of water, normal dynamics of cervical dilatation, positive condition of the fetus and mother.
During the birth period, the following rules are adhered to:
- They are allowed only in specialized medical institutions.
- The use of uterine stimulants based on prostaglandins (for example, Dinoprostone) is undesirable.
- A woman in labor is prohibited from pushing prematurely.
- When pushing, do not put pressure on the abdominal area.
- Anesthetic procedures are excluded due to the risk of missing the sensation of pain as a symptom of scar destruction.
- The need for constant monitoring of the condition of the uterine scar is taken into account.
- A thorough examination of the uterus after the birth of the baby is necessary.
Feeling the walls of the uterus and the healed suture after the placenta is delivered is necessary in order to completely exclude ruptures. Symptoms of a violation of the integrity of the suture may be a sharp weakness of labor contractions, the appearance of vomiting and nausea, as well as pain in the navel area. Palpation of the uterine cavity is performed under intravenous anesthesia and takes about five minutes.
If these symptoms appear and a sharp deterioration in the health of the mother in labor, emergency surgical intervention is indicated.
The physiological recovery period lasts from 6 to 8 weeks. It passes easier and more harmoniously than rehabilitation period as a result of a cesarean section. The main advantage is the opportunity to establish full lactation.
Whether it is possible or not depends on what indicators.
- If the indications for cesarean in the past related specifically to the situation during childbirth, and not directly to you. Then, if everything is fine in this pregnancy, then natural childbirth is possible.
- If the scar on the uterus after the first cesarean allows you to give birth. This is determined and the doctor, based on the results of the ultrasound, decides whether it can be tried or not.
- If in the past the pregnant woman had a natural birth, and then had a cesarean section. Provided that the uterine scar is strong, the presence of natural childbirth in the past is a favorable factor for future natural childbirth. The cervix, the birth canal, are already “giving birth.”
- If the child is large, with a lot of weight (more than 3500), then doctors may insist on surgery.
- If the indications for the previous cesarean were related to the mother herself, and did not disappear during this time. For example, if the mother had (and naturally still has) a narrow pelvis. Then doctors will recommend a caesarean section this time too.
Note. A frequent indication for cesarean section used to be a certain degree of myopia (myopia) in combination with a certain condition of the fundus (now myopia itself is not a direct indication for cesarean section). This problem does not go away for mothers over time. However, there are many cases when (with a strong uterine scar), with this eye condition, women give birth naturally after a cesarean section. They are taught to push “correctly”, directing the effort away from the face and eyes. The possibility of natural childbirth in such a situation must be considered by both a gynecologist and an ophthalmologist.
What is the difference between a normal natural birth and a natural birth after a cesarean section?
There are no special differences; for the woman in labor, everything happens the same as during a normal natural birth. There are several “related” points.
- Until the very moment of birth, the doctor will monitor the condition of the uterine scar, based on ultrasound results.
- The doctor delivering the baby must be ready at any moment to perform a caesarean section if necessary. The ward for the operation must be prepared (just in case), and the operating team is ready.
- During labor, the doctor should monitor the fetal heartbeat. This is done using electronic fetal monitoring (cardiotocography). An abnormal baby's heartbeat may be a sign possible problems with a scar. The scar on the uterus itself is a violation of the integrity of the uterus. If the scar on the uterus becomes thinner during childbirth, the tone of the uterus increases, contractions are more active, painful, and therefore the fetus experiences oxygen starvation, and the baby’s heartbeat suffers accordingly.
Weight
- So that the child is not too large.
- So that mom is not overweight ( excess weight, or obesity may be an indication for cesarean surgery).
It is important to eat properly and efficiently throughout pregnancy. On recent months you need to eat in small portions and as healthy as possible. Therefore, you should choose and buy in Mom’s Store for pregnant and nursing mothers, which you can take with you to the maternity hospital or eat after the birth of the baby. These products have an excellent composition, and most importantly, a balance between fats, proteins and carbohydrates. .
Note. Return of food and cosmetics at our expense is possible only if the packaging is undamaged.
Maternity hospital
If you have decided to have a natural birth, then you will need to take this seriously. The chosen maternity hospital should support this practice and create conditions for a successful birth. Unfortunately, this is not available in every maternity hospital, since it is easier and more reliable to carry out a planned cesarean section, citing the fact that there is already a scar on the uterus and there is no need to take risks.
Doctor
The choice of doctor is very important in this situation. You need a doctor who supports your decision and will create as safe an environment as possible for this. Therefore, look for reviews of the same women in labor.
Mood
According to reviews from many mothers who gave birth naturally after cesarean, the right attitude does real miracles. You need peace of mind and confidence in your choice as the right one for yourself and the baby. The only "but". Try to be sensible about the upcoming birth, and look at it only as a means of bringing a child into the world. The type of childbirth is not an assessment of you and is not an assessment of you as a mother or as a woman. Therefore, this is not the right mindset: I’ll give birth naturally, no matter what happens, I’m a real woman. And so: I will do everything so that the child is born naturally, provided that it is safe for me and the child.
Prepare thoroughly for breastfeeding and spending time from several days to a week in the maternity hospital. Buy from Mom's Store:
- (according to doctor's indications);
- and for comfortable feeding.
What can be the consequences of natural childbirth after cesarean?
- There is a possibility of divergence of the previous scar on the uterus. According to statistics, such a complication occurs in one case out of 200 such births. In case of such a discrepancy, it is done. First everyone possible ways the uterus is sutured, if it does not bleed, then everything is fine, the uterus is preserved. In case of multiple ruptures, significant hematoma or large intra-abdominal bleeding that threatens the woman’s life, the issue of removing the uterus is decided. The main danger of suture dehiscence is that it is often accompanied by bleeding into the abdominal cavity or into the muscle of the uterus, which threatens the life of the child and mother.
All other consequences relate simply to natural birth after cesarean; I will list them below.
- Pain in the perineum, often requiring sutures.
- Possible urinary incontinence in the first two to three months after birth.
- Possible prolapse of the uterus. To avoid this complication, you need to regularly perform exercises to strengthen the pelvic floor.
After childbirth, it is imperative to keep the entire body clean, especially to use exclusively, and pay attention to (nipple creams, recovery oils) in Mom’s Store female body after childbirth, oil for tissue healing from ruptures and cesarean section, oil for prenatal perineal massage, etc.).
Note. Returns of food and cosmetic products are only possible if the packaging is undamaged.
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