OBGYN Options After You Have Already Experienced A Cesarean Birth

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After delivering a baby through Cesarean Section (C-Section), many women may be unaware of the options available if they want to have children in the future. Unfortunately, many believe that a future C-Section is the only way to deliver babies again. If they had a bad experience with a C-Section to deliver a first child, they may opt to not have any more children if they fear that they only have a negative repeat experience. Fortunately, many women who have had a C-Section in the past are still capable of delivering healthy babies through a normal vaginal birth. Whether you're considering having another child or want to know if there are options for you besides a C-Section, here is information on your choices. 

What Is A C-Section? 

A C-Section is essentially a surgery to remove a baby if a regular vaginal birth might otherwise be harmful or dangerous to the child or the mother. A C-Section birth is often recommended in the case of multiple babies. It's more common for multiple-birth babies to be breech or positioned improperly, which can cause serious problems if they are delivered naturally. Furthermore, a woman with multiple fetuses may go into labor prematurely, which is another reason why a C-Section might be recommended. A baby that is unusually large may also need to be delivered by a C-Section. Some medical conditions, such as heart disease, pre-clampsia, and diabetes, may also make a doctor opt for a C-Section. 

The C-Section Surgery 

A C-Section is similar to any other surgery in that it requires sedation. A C-Section can be performed either with general anesthesia, which means that you are fully asleep, or with an epidural block, which lets you remain awake while being numb from the waist down. In this case, the sedative is administered into your spinal fluid through a tube that goes through your lower back. 

Recovering from A C-Section 

As with any surgery, a C-Section will take some time to recover from. You will be required to stay in the hospital for a set time to check for signs of infection and other post-op problems. Generally, it can take up to six weeks to recover physically and psychologically from a C-Section operation. Getting adequate rest and following your doctor's advice are critical for making a complete and timely recovery. 

Future Options 

Regardless of whether it was planned or performed on an emergency basis, many women have reservations about having children in the future after having a C-Section delivery. They may not wish to recreate a traumatic experience. They may also be hesitant about having another child if inherent risks might make a delivery less safe. But the good news is that in many cases, it is quite possible for women to deliver a baby through a normal vaginal birth after having a C-Section. This is especially true if the reason for the original C-Section was a multiple birth and not an underlying medical condition. 

Since no two pregnancies and C-Section deliveries are alike, your best bet is to speak with a knowledgeable OBGYN doctor about your future options for having children. He or she may say that it's okay to try a natural delivery. Depending on the initial reason for your C-Section surgery, however, your doctor may advise that you only have C-Section deliveries in the future. This includes the type of scarring that you have in your uterus from the initial C-Section. If your doctor thinks there's a risk that the scar will open, he or she will probably recommend a C-Section for future deliveries. 

Natural Birth Options: VBAC 

If you get clearance for a natural birth, great! Along with another C-Section, your other option for a birth method after a C-Section is called “Vaginal Birth After C-Section,” or “VBAC” for short. A VBAC is just what it sounds like, which is a normal vaginal birth. For many women, there are a number of benefits to delivering a baby in this method. For one, many women who deliver babies via VBAC, even if they've previously had a C-Section, can safely deliver a baby without having any complications. 

Advantages of A Vaginal Delivery 

As with any medical procedure, you always encounter more risks if you have a surgical procedure than if you don't. While a C-Section may be necessary for safety reasons, it does not mean that it's a risk-free procedure. A C-Section is still an invasive procedure that requires a longer hospital stay than a regular vaginal birth. It also carries a risk of infection and complications. A C-Section also leaves scars, which can be unsightly and potentially interfere with your options for bearing children in the future. There is also a risk of tissue damage during a C-Section that is not an inherent risk factor with a vaginal delivery. Additionally, many women prefer a vaginal delivery because it allows them to see their baby right after it is born, which is undeniably a very special moment. 

What is “TOLAC”? 

Sometimes, your doctor might recommend something called “TOLAC.” This stands for a “trial of labor after a C-Section delivery.” It basically means that your doctor is willing to proceed with a plan for a vaginal birth delivery, provided nothing happens that would render a natural birth unsafe. A vaginal birth is usually cleared if the initial reason that you had a C-Section was for multiple fetuses or an abnormal positioning of the fetus, such as a breech. If you're told that a TOLAC is an okay plan for your next child, you'll remain under the watchful eye of your doctor throughout your pregnancy to ensure that nothing comes up that might make a natural birth risky or impossible. The likelihood of having another C-Section after a TOLAC trial period works in your favor, as only about 40% of women who have a TOLAC for a pregnancy after a C-Section end up having to have another C-Section in the future. 

Risks of A TOLAC 

One of the biggest risks of a TOLAC that allows you to have a normal vaginal delivery is scarring from your 1st birth. The scar from your initial C-Section is a major determining factor in the safety and likelihood of you having a healthy vaginal delivery afterwards. Another factor to consider is that if you have more than one C-Section, the risk with a TOLAC are higher than if you have had only one C-Section in the past. 

Considerations to Keep in Mind 

After having a C-Section, women often have mixed feelings about the best way to deliver children in the future if they choose to do so. Ultimately, the best choice comes down to a decision between you and your doctor. There are a number of factors and considerations to keep in mind when you're contemplating your options. One is acknowledging that you had a C-Section in the first place. If you were originally healthy and only had surgery to avoid complications from a breech birth, you might be a great candidate for a vaginal delivery. However, if you have an underlying health problem that poses a risk for you and any future child, a C-Section might be the best bet. Knowing the type of post-surgery scarring in your uterus and your options for accessing emergency delivery care in case of last-minute complications are other important considerations to keep in mind when debating whether to have a C-Section or a VBAC. Talking with your doctor is the best way to determine the right option for you.