VAGINAL DELIVERY AFTER CESAREAN

A woman with a cesarean section is called "vaginal birth after cesarean (VBAC, vaginal birth after cesarean)" or "normal birth after cesarean". This is not always possible. But it is possible when certain conditions are met. It is also true that there is a situation that is not always possible and not always safe. For this reason, women who have had a cesarean once receive suggestions that they will always have a cesarean in their future pregnancy. For this reason, the words "once cesarean, always cesarean" generally apply.
In what cases, vaginal delivery after cesarean is not suitable?
- If the situation that requires you to be cesarean is still going on, you will have to be cesarean again. For example, if cesarean was required because of any illness of the mother and this disease still continues.
- If the uterus has been cut vertically during the previous cesarean section, then normal delivery cannot be performed because the risk of rupture of the uterus during normal delivery is very high. However, in cesarean sections, the incision perpendicular to the uterine wall is rarely made and mostly the transverse incision is made. This incision is not the incision made on your skin, but the incision made on the uterine wall. Even if the skin is cut on its side, the incision in the uterine wall may be erect. Only the doctor performing the cesarean can know this.
- If the situation requiring cesarean before is incompatibility of the maternal birth roof, this situation will not change and normal birth will not be possible.
- Those with multiple pregnancies
- Those with high blood pressure and diabetes
- Those who had previous uterus operations (such as fibroid surgery) other than cesarean
- Normal delivery should not be tried after cesarean in places where emergency cesarean surgery cannot be performed.
Who is more suitable for vaginal delivery after cesarean section:
- Those who have had only one cesarean once before
- The pelvic structure is suitable for normal birth
- Those who have not previously had surgery for the uterus (such as myomectomy) other than cesarean
- Those who do not have any disease that will prevent normal birth
- The baby's weight is not more than normal limits and his head is in the vertex position
Just as cesarean delivery and normal delivery have some different advantages and risks, normal delivery after cesarean has some advantages and risks. For example, with normal delivery after cesarean, the mother will once again be relieved of being cesarean and complications such as postpartum pain, infection, bleeding will be less.
However, the biggest risk of normal delivery after cesarean is the risk of uterine rupture, which can sometimes be repaired by repairing the torn area, and sometimes it can be serious enough to require complete removal of the uterus. Even with excessive bleeding, it can endanger the life of the mother. Although studies have shown that vaginal births after cesarean section have been successful at the rate of 60-80%, it is an application that is not considered warm and not tried due to its important risks. Sometimes, if 5 or 10 years have passed since cesarean, there may now be false feelings that normal birth may be risk-free. There is no point in this, and even after many years, nothing changes.
Sometimes, when a candidate who has had a cesarean section has suffered and her cervix is ​​opened too much, she can be delivered by the normal way.


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