Can there be a natural birth after cesarean? This question bothers quite a number of women whose first child was born by Caesarean section. The majority of these women complain that the doctor - a gynecologist, which they are observed, stubbornly insists that this time delivery is carried out by Caesarean section.
And they motivate their decision very razmyvchato - because the first pregnancy ended by caesarean section. And this practice is very popular - almost all clinic is practiced. Moreover, after the second pregnancy, doctors are beginning to agitate in favor of the women sterilized. They motivate the recommendation that the third pregnancy because of the poor state of the uterine scar is very dangerous not only for the life of the fetus, but also to maternal life.
But in recent years the views of obstetricians - gynecologists to this problem has changed radically. And despite the fact that there remain instances where the following after cesarean births should also be carried out by Caesarean section, they became much smaller. However, more and more doctors prefer to give these women the opportunity to have a baby naturally - strictly speaking, during the whole period of pregnancy, doctors systematically prepare the pregnant woman to the natural childbirth.
When cesarean section can not be avoided?
Before we talk about how it is possible to birth naturally after cesarean section, it is necessary to find out in which cases it is absolutely impossible. These cases include:
- Anatomical features women
As a rule, often repeated cesarean section is done to those women who have the specific features of the anatomical structure of the body. It is these anatomical features was the reason that the previous pregnancy ended by caesarean section. Most often these anatomical pathologically narrow pelvis is female, which does not allow the child to pass through the birth canal.
In addition, sometimes there are somatic anatomical features - such as a serious traumatic brain injury, myopathy highly partial retinal detachment, in short, all the conditions that exclude the possibility of bearing-down period. Tragically, these states almost never pass even with the passage of time, and, therefore, strict indications for cesarean section remain on throughout the woman's reproductive years.
It is rare, but still there are cases when a woman bears a multiple pregnancy for the first time, and the doctors perform cesarean delivery. But repeated pregnancy is also multiple. In this situation, an obstetrician - gynecologist, most likely as an example the decision to conduct caesarean sections. Firstly, the production of two or more children has increased load on the uterine scar. And secondly, most of the kids from multiple pregnancies have a small weight, so the passage through the birth canal can become for them a very severe test.
Despite the fact that the mere existence of the uterine scar from a cesarean section should not be a contraindication to the natural delivery, very much depends on its condition. Doctor using ultrasound should carefully assess the condition of uterine scar from a previous caesarean section. And only if his condition allows to have a naturally doctor so decides. Otherwise avoid caesarean section is unlikely to be as natural childbirth may become a threat to life and health of mother and baby.
By the way, very much depends on what kind of scar a woman - a longitudinal scar the only option of delivery in subsequent pregnancies - repeated cesarean section. In addition, if the interval between pregnancies was less than two years, or if the retransmission preceded pregnancy miscarriage or abortion, the chances of natural childbirth will be low. This is due to the fact that the rumen due to surgical curettage is much thinner.
In that case, if this pregnancy is not the second, and the third, and the two ended the previous Caesarean section, in almost all cases it will be the only possible delivery was by Caesarean section. Despite the fact that the holding of the third Caesarean section is much more difficult from a technical point of view, the natural childbirth, doctors prefer not to risk the life of any woman, no crumbs of life - a danger for them is too great.
Furthermore, repeated caesarean section is often accompanied by a number of various complications, in contrast to the first. And the most common damage to the bladder and ureters. As a result, developing pelvic adhesions - adhesions affect almost all internal organs. In addition, often there are complications such as thrombosis, anemia. This makes natural childbirth is extremely dangerous to the health and life of a child and a woman.
Repeat cesarean section. The good or evil?
Sometimes women do insist on a repeated cesarean for fear of pain during vaginal delivery. But in fact, cesarean section, despite the fact that it is well established for decades, on - still carries certain risks. And the body of a pregnant woman, it affects not the best way.
Typically, repeated cesarean time lasts longer than the first one. So, to a large extent as the increased risk of fetal hypoxia and cerebrovascular accidents crumbs due to the prolonged exposure to anesthetic drugs. In addition, a cesarean section - it is always a certain proportion of the risk that may be damaged cervical spine crumbs.
Moreover, even the most modern methods of anesthesia, such as an epidural, you still can not pass in vain for the female organism - to a greater or lesser extent, but they have a certain negative impact on a woman's body. We should not forget about the fact that a caesarean section - abdominal surgery, and hence the problems with joints, sometimes very serious, and no one is immune.
That is why doctors - gynecologists and surgeons do not get tired to repeat in unison that a caesarean section is a fairly serious threat to both mother and for her baby. Therefore, the repeated cesarean is resorted to only if there is strong evidence for such a mode of delivery. The physician should carefully weigh the pros and cons, possible risks and potential benefits - and only after that can make the right decision.
After all, the advantage of natural childbirth is obvious - this is the way to birth nature has provided. And it is unlikely that a person can come up with - something better. Yes, and the process of restoring the female body after a natural birth takes much less time than after a cesarean section. The same applies to breastfeeding - for its establishment after cesarean section may need much more time and effort than after vaginal delivery.
So what to choose?
So, as we have seen, the best option for re-delivery after cesarean section is still natural childbirth. Ideally, the preparation for it must begin immediately after the birth of the first baby by Caesarean section. The first thing you need to do a doctor - is to determine what exactly was the first indication for cesarean section. It has already been described a number of cases, eliminating the opportunity to vaginal birth after cesarean.
In the same case, if the cause of cesarean section served as a strong late toxicosis, placental abruption or previa her - a woman is very high chances that vaginal birth after cesarean section will be possible.
In addition, even during the first caesarean section doctors - surgeons must take care that the woman was able to give birth to his second child naturally. To do this, it is important to find the right quality suture, and the suture technique should be given special attention.
At discharge from the hospital a woman have to be a statement issued on his hands, which will be described in detail the method of birthing, the reasons that forced doctors to resort to Caesarean section, the very course of the operation - which was used anesthetic, suture and suture technology.
Be sure to make a photocopy of these documents and keep it at home, with all the other important documents. This will help you protect yourself from the situation with the loss of your medical records - unfortunately, this sometimes happens. And even computerization of health centers will not be able to completely eliminate the possibility.
At discharge, the doctor will explain in detail a young mother how she should behave during the rehabilitation period in order to avoid possible complications in the future. And women should strictly comply with all recommendations until uniform. In addition, in any case can not be ignored preventive visits to doctors - gynecologists - this measure will help to identify possible complications in their very early stages.
Also, ideally subsequent pregnancy should be planned. And even before the pre-pregnant women should see a doctor - a gynecologist and pass a study of the uterine scar. There are two types of such studies - hysterography (X-ray weld) and hysteroscopy (joint research with the help of a special probe). Typically, such research would be appropriate not earlier than one year after caesarean section.
In the event that the recovery process of the body postpartum women completed normally, the study of uterine scar he hardly visualized. The first thing the doctor must establish that produces research - this is what type of the formed tissue predominates in the rumen. Ideally, this should be muscle tissue, but not connecting.
Strictly speaking, it is a year later, during the study of uterine scar is becoming abundantly clear his condition, he's at this point is completely formed, and is unlikely to change its status globally. Incidentally, it is the results of these studies in most cases and play a crucial role in making decisions about your doctor the possibility of a natural birth, and not a secondary cesarean section.
Pregnancy after cesarean
Many mothers begin to worry about the condition of their child since the day as soon as they find out about her pregnancy. And the most common fear - that the growing uterus sooner or later will burst at its scars. But these fears are totally groundless - during the next pregnancy after a caesarean section is not different from that in the previous.
The only condition is that the woman should strictly observe - this is an early statement on the account in female consultation, regular visits to all scheduled scans doctor - a gynecologist, the fulfillment of all his assignments, advice and guidance. Very nice it would be as soon as possible to find a doctor - a gynecologist, who will then take delivery.
As a rule, this doctor will be on throughout the pregnancy carefully monitor the condition of the mother of the scar as using ultrasound or by means of palpation - hand research. By the way, if a woman palpation uterine scar feels pain, the second birth after cesarean naturally it could not be counted.
However, the final decision on the possibility, or, on the contrary, the impossibility of natural birth, doctors take 35 weeks of pregnancy. Expectant mother again appoint an ultrasound study to confirm the viability of the scar, the correct position of the fetus - longitudinal and cephalic presentation. In addition, it is important to placenta previa. In that case, if all the indicators are normal, and no other woman has no contraindications - doctors will start to prepare the future moms to natural childbirth.
In addition, a very important one more nuance - how donoshen pregnancy. Natural childbirth in such a situation can occur only if the pregnancy will be full-term - more than 37 weeks, but the child should not be too big - more than 4000 grams. Otherwise, the risk is greatly enhanced, and often exceeds the potential benefits.
The period of hospitalization in the maternity ward
It is also often raises the question of the length of hospitalization of women in the maternity ward, which is planning a natural birth after cesarean. It is common practice, when a pregnant woman is put into a maternity hospital in advance, for one - two weeks before the expected date of delivery.
As a rule, then the following happens - about the day of the expected date of birth, or a little earlier, doctors punctured fetal bladder then begin to artificially stimulate the onset of labor. The whole procedure is carried out in the daytime, when all doctors are on their jobs. Doctors explain their actions providing these maximum safety of mother and baby.
However, such practices exist not only supporters but also fierce opponents. They justify their position by the fact that artificial induction of labor is only one danger, but lethal - uterine scar rupture. Indeed, in that case, if there is an artificial induction of labor, the cervix opens abruptly and unevenly. In that case the delivery begins naturally cervical dilation occurs very slowly, which considerably reduces the load on the uterus itself.
During natural childbirth is a risk that the scar burst unexpectedly equal to almost zero - any experienced doctor will be able to observe in a timely manner the threat and take all necessary measures in this situation. Strictly speaking, all such deliveries should be conducted under the supervision tripled and attention to the condition of a woman giving birth. After peeling the placenta, it is imperative manual study of the state of the scar, of course, under general anesthesia.
The impact on the child's birth
Despite the fact that in recent years more and more obstetricians - gynecologists are actively promoting natural birth after Caesarean section, of course, provided that there is no contraindication to this, in fact, the situation is not so strong. And, despite the fact that almost all women are willing to go through a longer period of recovery after repeated cesarean section for getting rid of the pain of labor, few of them think about how a child affected by a particular method of birth.
But child labor - much more stress than his mother, because during the passage of the baby through the birth canal, he felt a strong pressure on the bones of the skull. However, while a baby born by caesarean section stress immeasurably greater than during natural childbirth. After all, the child time caesarean section into the environment is very harsh, rather than gradually, as it should be OK.
And precisely because of this sudden birth of a child in the body - simply does not have time to develop the necessary quantity so-called stress hormone. Purpose of this hormone - facilitating the adaptation of the child's body to the environment. That is why almost all the kids who were born by Caesarean section. Performance of all vital processes in these children reach their normal levels until the end of the seventh - tenth week.
Think for yourself, decide for yourself ...
As you can see for yourself, natural childbirth is still much better for both mother and for the baby.