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If I had a caesarean section, is it possible to give birth naturally? Is it possible to give birth on your own after a cesarean section and what might be the consequences? Is it possible to give birth on your own after two cesarean sections?

Caesarean section is an operative method of delivery in which abdominal surgery is performed to remove the baby from the mother's womb if it 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 fact is that after surgery, 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: the probability of a 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 of 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:

  1. adhesions from the first operations increase the risk of injury to the intestines or bladder;
  2. 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 medications, including hormonal ones. You will need 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:

  1. scar rupture;
  2. fetal hypoxia;
  3. perineal rupture;
  4. heavy bleeding;
  5. deterioration of uterine contractility during childbirth;
  6. uterine prolapse;
  7. birth injuries.

Contraindications

After a caesarean section, the woman receives a statement in the medical record, which states in detail why the decision was made to have an operative delivery.

This is done in order to make a prediction in advance whether the woman will be able to give birth on her own. 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, there is not only a physiological factor, but also a psychological one. 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: obstetricians-gynecologists do not recommend resorting to anesthesia during natural childbirth. Epidural anesthesia can slow down the labor 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 is of normal size and labor begins on time, there is every chance of a favorable natural birth.

Risk factors are:

  1. large fruit;
  2. mother's age is more than 35-40 years;
  3. the presence of two or more scars on the uterus;
  4. 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 advised to listen to the doctor’s advice and their inner voice: usually the mother’s instinct tells her what is the best thing to do.

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, avoid nervous stress and lead a healthy lifestyle, follow all doctor’s recommendations and plan a 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:

Childbirth after cesarean section raises many questions for women planning a second pregnancy. Doctors point out possible complications of the process. Let's look at the situation in detail, find out when you can give birth after a caesarean section and how the process is carried out.

Is it possible to give birth after a cesarean section?

According to obstetric practice, the second birth after a caesarean section should be carried out in the same way. The reason for this is availability. This area of ​​tissue has low elasticity, which increases the likelihood of rupture of the reproductive organ. As a result, a complication develops - uterine bleeding occurs. The situation requires urgent surgical intervention and is dangerous due to the possible death of the mother in labor.

At the same time, modern studies of Western neonatal centers prove that childbirth after a cesarean section is possible using the classical method - through the birth canal. Thus, British doctors calculated: 75% of women who gave birth naturally had no complications during labor. As for the consequences for the fetus (hypoxia, neurological complications), they are recorded in 1% of cases. Taking this information into account, obstetricians give a positive answer to a woman’s question about whether she can give birth herself after a caesarean section.

How soon can you give birth after a cesarean section?

Women who have undergone surgery are often concerned about the question of how long it will take to give birth after a cesarean section. Doctors do not give a clear time period that must pass before planning the next pregnancy. It all depends on the speed of regeneration of uterine tissue and the formation of a scar on it. A preliminary examination helps determine this fact.

Obstetricians themselves try to adhere to the rule, which states that childbirth after a caesarean section should occur no earlier than 2 years later. This fact is due to the failure of the scar - the likelihood of development increases. In addition, curettage during pregnancy also thins the uterine tissue, which negatively affects the restoration of the reproductive organ. Whether it is possible for a specific woman to give birth herself after a caesarean section is determined by the doctor.

Is it possible to give birth after a cesarean section in a year?


In each specific case, when it is possible to give birth after a cesarean section, the doctor determines. For this purpose, a comprehensive examination of the uterus is prescribed, which includes an ultrasound and examination in a gynecological chair. Particular attention is paid to the condition of the postoperative scar. This area of ​​tissue has low extensibility, which increases the risk of uterine rupture in this place. After the examination, the woman receives recommendations for planning her next pregnancy.

Is it possible to have a natural birth after a caesarean section?

Women planning a second pregnancy are often interested in the question of whether it is possible to give birth on their own after a cesarean section. Doctors do not deny this possibility. At the same time, they point out the factors that determine the variant of this delivery. Among them:

  • scar condition;
  • number of cesarean sections in history;
  • absence of concomitant diseases of the reproductive system.

Contraindications for natural childbirth after cesarean

It is worth noting that in such situations, not all women are allowed to give birth naturally. This is due to the possibility of developing complications - after a cesarean section, the uterus acquires some features. Contraindications for vaginal birth include:

  • longitudinal scar on the uterus;
  • placenta previa in the scar area;
  • peppery position of the fetus;
  • large fruit;
  • anatomically narrow pelvis;
  • oncological process.

Preparing for childbirth after cesarean

Independent childbirth after cesarean section requires a preparatory stage. It begins with assessing the condition of the reproductive organ. To do this, the woman provides doctors with an extract from the maternity hospital, which contains the following information:

  • reasons for previous cesarean section;
  • duration of the anhydrous period, childbirth;
  • suturing method, material used;
  • volume of blood lost;
  • list of drugs used.

Based on the information received, doctors draw conclusions and conduct the necessary examination. It includes:

  • Ultrasound of the pelvis;
  • laboratory tests: blood test, urine test, hormone levels;
  • exclusion of chronic foci of inflammation.

How is natural childbirth after caesarean?

Natural birth after cesarean section is always planned. They are carried out at 39-40 weeks. The process begins with an amniotomy - the opening of the amniotic sac, which starts the process of childbirth. The delivery itself is carried out in the same order as always. Special attention is paid to the condition of the scar. At its initial divergence and the appearance of blood, an emergency cesarean section is started.

How many times can you give birth after cesarean?


When asked how many times a woman can give birth after a cesarean section, obstetricians previously answered that a woman can only have 2 cesareans in her entire life. Modern developments in medicine and obstetrics allow for several deliveries after such an operation. Decisions of this kind are made by a team of doctors who evaluate the available research results, the condition of the reproductive organ, and the scar formed on it.

Western obstetricians have long used vaginal delivery after cesarean section. In this case, a low percentage of complications is recorded. This is achieved through careful study of the process of such delivery, continuous monitoring of the condition of the mother in labor during the birth of the baby. Cases have been recorded where a woman after such an operation gives birth to 2 children through natural birth. At the same time, the babies themselves do not have any pathologies.

Natural birth after two caesarean sections

As mentioned above, the decision about whether it is possible to give birth naturally after a caesarean section is made by the doctor. Domestic obstetricians adhere to the principle that 2 previous cesarean sections are an indication for a third. Previously, a woman was completely prohibited from giving birth in this case, having undergone sterilization (tubal ligation) after the second operation.

Natural birth after cesarean section is possible in women with a transverse incision, one scar, no contraindications from the fetus and no serious illnesses in the mother. After the second and third cesarean, emergency with vertical dissection of the uterus, surgery is recommended.

When choosing a vaginal method of delivery, you need to meet a number of conditions - plan a pregnancy in 2-3 years, register early, constantly monitor the condition of the scar, go to the hospital 2 weeks before the expected birth. Conducting the birth process has its own peculiarities: pain relief is carried out with caution, they try to avoid stimulation, and after the birth of the placenta, an examination of the uterus is necessary.

Natural birth after cesarean section (CS) is dangerous due to uterine rupture due to an incompetent scar. Indications and contraindications are determined only by a hospital doctor after an in-depth examination of the woman in labor.

Why you can’t give birth on your own after a caesarean section

After a caesarean section, you should not give birth yourself only if there is a threat to the health of the mother and child. Contraindications for natural childbirth include:

  • more than two scars on the uterus or 1, but on the back wall;
  • vertical incision for caesarean section;
  • surgical removal of fibroids, especially laparoscopically;
  • location of the placenta (baby place) on the scar;
  • severe toxicosis of the second half of pregnancy;
  • diseases of women - high degree of myopia, hypertension, pathologies of the heart, kidneys, lungs, diabetes.

On the part of the fetus, restrictions are considered:

  • weight from 3800 g;
  • multiple births;
  • transverse arrangement;
  • or other than the head one.

Types of breech presentation of the fetus

Who is allowed to give birth after a caesarean section?

Conditions under which a woman may be advised to give birth on her own:

  • uncomplicated course of the current pregnancy;
  • full term, the bladder is not opened, the cervix is ​​mature;
  • the child has no diseases;
  • the scar is transverse and substantial (3-5 mm wide);
  • more than 2 years have passed since the previous cesarean;
  • age up to 35 years;
  • had a previous vaginal birth;
  • The first cesarean section was scheduled due to weak labor, placenta previa, multiple pregnancies, and the postoperative period passed without complications.

Transverse incision during caesarean section

The woman in labor must be psychologically fully prepared for a normal birth, and in the hospital she must be able to provide:

  • presence of an anesthesiology department;
  • intensive care wards for mothers and newborns;
  • blood supply;
  • switch to a caesarean section at any time (team of doctors, equipment for surgery, artificial ventilation);
  • qualified gynecologists with experience in childbirth with a uterine scar.

Statistics

Based on observations of 34,000 women after cesarean section, the following results were published:

  • 18,000 expressed a desire to give birth in the usual way, the rest chose surgery;
  • of those who agreed to a natural birth, they were successful in 74%, and 26% had to undergo a repeat cesarean section already in the process of delivery;
  • Uterine rupture was found in 0.7% of women in labor, 2 children could not be saved, seven were found to have impaired brain function due to cessation of nutrition through the placenta during complicated childbirth;
  • maternal mortality for vaginal delivery is 3 people, for cesarean delivery - 7 (0.04% more).

A larger study showed comparable risks of adverse outcomes for mother and baby for both modes of delivery after cesarean.

Positive aspects of childbirth after cesarean section

If it is possible to have a normal birth after a cesarean section, then this is the most preferable option because:

  • the risk of blood loss after surgery is lower, the uterus contracts naturally;
  • infection penetrates into the uterine cavity less often;
  • the recovery period is shorter, hormonal levels normalize faster;
  • lactation is stimulated;
  • repeat cesarean section often causes severe adhesions in the abdominal cavity, which leads to chronic abdominal pain;
  • Children born in the normal way have better immune protection, are less likely to suffer from allergies, their anti-stress mechanism has time to turn on, and with a caesarean section there is a sharp transition from intrauterine development to the external air environment.

Negative aspects of a second birth after cesarean section

After the first caesarean section, the second birth also has negative consequences:

  • perineal ruptures;
  • urinary incontinence or frequent urination;
  • risk of rupture and severe bleeding requiring blood transfusion.

Postpartum urinary incontinence

Is it possible to give birth after a caesarean section if you insist?

After a caesarean section, you can give birth yourself, but it is important to strictly follow the recommendations of the gynecologist. The woman’s wishes are always taken into account, but if there are absolute contraindications, the doctor may insist on surgery.

Is it possible after 2 caesareans?

After 2 caesarean sections you should not give birth on your own. Two scars on the uterus lead to impaired coordination of labor, so the risks of complications increase by 2 times. A woman needs to know that the requirement to have a natural birth puts her health and the life of her child at risk.

Can they force me to give birth on my own?

No one can force you to give birth on your own. A woman always has the right to choose the method of childbirth, and a caesarean section can be performed at will, even in the absence of indications. It is important to take into account that the doctor has a better idea of ​​the optimal delivery option. If you don’t trust his opinion, you can always get an alternative consultation with another specialist.

Refusal of natural childbirth

A woman may be denied a natural birth if there are direct indications for a cesarean section:

  • narrow pelvis,
  • large fruit,
  • age from 40 years,
  • weakness of labor,
  • placental abruption,
  • chronic infections,
  • abnormalities in the structure of the uterus.

A woman herself can refuse a cesarean section, but she will be required to confirm this in writing. Such a statement will indicate that she is aware of the risk of death for her and the fetus and takes responsibility for the consequences.

Watch this video about the benefits and dangers of natural childbirth after cesarean:

How to give birth yourself after cesarean

To successfully give birth yourself after a cesarean section, you need to plan your pregnancy at the optimal time (from 2 to 10 years), strictly follow all instructions from doctors.

After how long

A period of 2-3 years is considered optimal. If conception occurred in the first year, then doctors strongly recommend terminating the pregnancy. This is explained by the fact that if it is still weak, there is a high risk of its rupture. It must be taken into account that abortion during this period is also dangerous.

Therefore, a woman needs to protect herself very carefully. For this purpose, drugs are usually prescribed in tablets, which have a contraceptive effect and at the same time restore hormonal levels.

After two years, you need to conduct an in-depth examination of the condition of the uterine scar. For this, the gynecologist prescribes an ultrasound, examination with a hysteroscope (insertion of a conductor that displays visual data on the screen), hysterography (filling the uterine cavity with contrast).

If the connective tissue and muscle tissue are fully formed, then pregnancy is planned. It does not matter whether the woman gives birth on her own or has a repeat cesarean section. Therefore, it is recommended to wait 2 years.


Incompetent scar on the uterus after cesarean section

After 5 years, it is also quite possible to count on a normal birth in the absence of contraindications, but if more than 10 years have passed, then the chances decrease. Conception after such a long period is not excluded, but according to age criteria, most often the gynecologist will still recommend surgical delivery.

How to prepare

Preparing for a natural birth after cesarean involves planning your pregnancy and registering it as early as possible. Throughout pregnancy, the woman is monitored in the clinic, and if a threat to health arises, she is hospitalized in a hospital.

It is important to consider that until the 35th week, no doctor can determine how the birth will take place. In order to choose the optimal method and period, the patient is sent to the maternity hospital for examination at 36-37 weeks of gestation.

How is pregnancy and childbirth going?

Pregnancy usually goes away after a cesarean section, but constant medical supervision is needed, and the course of labor has its own peculiarities - avoid stimulation and pressure on the uterus, you need to examine it after the placenta has passed.

Are there any special features of pregnancy?

In 75% of women with a uterine scar, the course of pregnancy is normal, but in 25% there is a threat of premature birth or early miscarriage. Therefore, everyone needs constant monitoring by a gynecologist; it is especially important in the last weeks.

Harbingers of childbirth

The very first harbingers of the imminent onset of labor are nagging pain in the lumbar region, drooping of the abdomen and loss of body weight. They appear in 7-10 days. Then the mucus plug comes off, which is manifested by bloody spotting.

One of the important features of labor after a cesarean section is its spontaneous onset. It is noted in 95% of patients, so relying on symptoms or expecting the classic course of the prenatal period is dangerous.

Contractions

Contractions are at first rare and less painful, but gradually they become stronger and more rhythmic. It is strictly forbidden to wait for their growth at home, since the first signs of the onset of labor must be fully monitored by a doctor. Therefore, women in labor with a uterine scar are hospitalized in advance. If for some reason a woman is not in the hospital, then when the first sensations of uterine contraction appear, you should urgently call an ambulance.

How to give birth

Giving birth after a cesarean section should only be done in institutions that can urgently perform a second operation if necessary. Conducting the birth process itself has the following features:

  • the choice of method of delivery (natural or surgical) is influenced by the course of the prenatal period, the time of water breaking, the dynamics of dilatation of the cervical part of the uterus, the condition of the mother and child;
  • there is a danger of early discharge of water, weakness of uterine contractions, slow opening of the cervix;
  • It is not allowed to push until the cervix is ​​completely open, or to press on the stomach while pushing;
  • it is necessary to constantly monitor the condition of the scar;
  • if signs of rupture appear, an urgent cesarean section is performed, these include: sudden cessation of labor, nausea, retching, severe pain in the navel area.

The course of labor when the suture is in normal condition does not differ significantly, but after the birth of the child and the passage of the placenta, an examination of the uterine cavity is necessary. This is necessary in order not to miss signs of scar ruptures. An anesthetic is injected into the woman's vein and the integrity of the uterine wall is examined manually.

The recovery period during a normal delivery through the vaginal tract is easier than after a cesarean section. It lasts up to 1.5-2 months, the risks of complications are much lower. The woman is discharged 3-4 days after a follow-up examination and ultrasound.

Is it possible to induce labor after a caesarean section?

Stimulation of labor after cesarean section is considered undesirable, especially with prostaglandins (for example, Dinoprostone). Therefore, most often the period of contractions lasts quite a long time, but it is safer.

Nevertheless, in some maternity hospitals they try to administer small doses of Oxytocin, puncture the bladder at all signs of readiness for labor, in order to carry out childbirth during the daytime. This is caused by the need to be fully prepared for an emergency cesarean section if the health of the mother and fetus is at risk.

The second controversial issue is pain management. Not all doctors recognize it as acceptable, as they are afraid to miss signs of scar rupture. But with good technical equipment of the hospital and highly qualified gynecologist, experience in managing childbirth after caesarean section, epidural anesthesia is used. An anesthetic is injected into the area of ​​the lumbar vertebrae.

Is it possible to give birth after a third caesarean section?

In the vast majority of cases, after the third cesarean section, it is not recommended to give birth on your own. Even two previous operations and more than one scar on the uterus are an indisputable indication for repeated surgical management of childbirth. The chances of a natural birth without complications are close to zero. Therefore, it is much safer for women and the baby to have a fourth caesarean section.

When planning your next pregnancy, it is extremely important to take into account the doctor’s opinion, since the second operation is already proceeding with difficulties due to adhesions in the abdominal cavity. Another problem is the thinning of the uterine wall and difficulties with its suturing, due to which the time of cesarean section increases by 2.5 times, the degree of blood loss is higher, and the risk of injury to neighboring organs is higher.

All this is not safe for the mother in labor. The uterine cavity usually contracts slightly after repeated intervention, and placenta accreta is possible. In these cases, removal of the uterus will be necessary to save the woman's life.

Natural birth after cesarean section is possible with a well-formed scar. You need to prepare for them and go to the maternity hospital 2 weeks in advance to decide on the method of delivery. If there are two or more scars on the uterus or a vertical incision, repeat surgery is recommended.

Useful video

Watch this video about whether natural childbirth is possible after a caesarean section:

Caesarean section is a delivery operation during which the newborn is removed through a specially made incision in the peritoneum and uterus. Today, such surgical intervention is the most common in obstetric and gynecological practice due to the large number of pathologies in pregnant women. Caesarean section can be planned or emergency if complications arise during spontaneous childbirth. And if everything is clear with the indications for the operation and the course of the procedure, then the question arises, how does childbirth go after a cesarean section? Is it possible to have a second child naturally?

There are no absolute contraindications to natural delivery after surgical birth. But it is worth considering several mandatory factors so that the next pregnancy and childbirth after cesarean ends safely. During this operation, an abdominal incision is always made in the abdominal cavity and body of the uterus, after which a scar is left on them, which needs time to heal. You should know that it can diverge at any time during pregnancy due to stretching of the peritoneal tissue. This is also possible during childbirth due to contraction of overstretched uterine muscles.

Therefore, childbirth a year after cesarean is undesirable. A woman must take careful precautions to avoid conception. Also, during this period you cannot have an abortion, since mechanical impact on the walls of the uterus can lead to partial or complete rupture of the suture.

Gynecologists recommend getting pregnant again only 2-3 years after the birth of your first child through surgery. After this time, the scar is considered healthy, that is, well healed, and the muscle tissue near it is completely restored. It is elastic and contracts well during contractions during labor. From this moment on, a favorable period begins for bearing the next child, and repeated births after cesarean section will go well.

If pregnancy occurs 5 or more years after surgery, then during childbirth the suture on the uterus may also come apart, as it will be too rigid and difficult to stretch.

Why is it advisable to give birth naturally after a cesarean section?

Is it possible to have a natural birth after a caesarean section? Yes, and the gynecologist will not insist on repeat surgery if there are no other contraindications. Moreover, doctors are inclined to believe that natural second births after cesarean are even desirable. The probability of successful natural delivery in this case reaches 70%.

Positive points in favor of vaginal birth after cesarean:

  1. Repeated childbirth after a caesarean section is safer for both mother and newborn. They enable the woman to give birth repeatedly in the future.
  2. The operation can be performed up to 3 times without serious consequences. With each subsequent one, the risk for the child and mother increases. The second birth in a row, which took place by cesarean, sharply reduces the likelihood of independent childbirth in the future. And childbirth after 2 cesarean sections almost always takes place with the help of surgical intervention.
  3. After a normal birth, a woman returns to normal much faster. Reproductive function is restored faster. The risk of complications is minimal compared to a repeat cesarean section, after which menstrual irregularities and the development of other consequences cannot be ruled out. This can lead to difficulty conceiving again.
  4. When a baby is born in the usual way, he produces a stress hormone that promotes better adaptation to the world around him.

Indications for repeat cesarean section

Natural birth after cesarean section is impossible if the following factors occur:

  • detection of signs of scar failure according to ultrasound data and symptoms, especially if less than 2 years have passed since the first such operation;
  • longitudinal incision after the first cesarean section;
  • two or more scars from previous artificial births;
  • attachment of the placenta in the area of ​​the uterine scar;
  • narrow pelvis;
  • long period between births (5 years or more);
  • oncological damage to any organ of the reproductive system, for example, an ovarian tumor;
  • deformation of the pelvic bones;
  • pelvic or transverse;
  • too much ;
  • diabetes mellitus in a pregnant woman or serious vision problems - retinal detachment, high degree of myopia;
  • diseases of the cardiovascular and nervous system, as well as in the expectant mother;
  • abnormalities of fetal development or other pathologies that arose during intrauterine development ().

Preparing for independent re-birth after cesarean

In order for a future pregnancy to proceed normally and end with a natural birth, preparation for this should begin immediately after the first cesarean section. You should follow all the doctor’s recommendations given to the woman in labor for recovery in the postoperative period. During the first 2 years, contraception is required to prevent re-pregnancy. Abortions cannot be performed during this period.

Before conception, both women and men should be examined to identify diseases that may affect the course of pregnancy and be a contraindication to natural childbirth. A woman must undergo gynecological diagnostics to assess the condition of the uterine scar (hysteroscopy, hysterography and ultrasound procedures).

To make the final choice of delivery method, the woman is routinely hospitalized at 37-38 weeks of gestation. In the hospital she undergoes a full comprehensive examination. The condition of the fetus is also assessed using cardiotocography, Doppler and other diagnostic methods.

Features of the process of normal childbirth after cesarean

Independent childbirth after a cesarean section follows the usual scenario, with contractions, pushing, the birth of the baby and the delivery of the placenta.

But there are some points that are contraindicated during natural childbirth after cesarean:

  • Labor stimulation is strictly prohibited. An injection of enzaprost or oxytocin can cause rupture of the suture in the uterus.
  • You can't start pushing too early.
  • When pushing, the doctor does not use pressure on the abdomen.
  • Anesthesia is excluded so as not to miss the pain from scar rupture.

After the placenta is delivered, the obstetrician-gynecologist, using a sterile glove, examines the walls of the uterus, especially the suture area, to exclude partial or complete rupture. If the suspicions are confirmed, the woman in labor will undergo emergency surgery. If complications arise during spontaneous labor, an unplanned cesarean section must be performed.

Complications of natural childbirth after a previous cesarean:

  • A healed incision on the uterus can affect the course of pregnancy. Every third pregnant woman has a high risk of premature termination of pregnancy at any stage.
  • Because of the suture, some people develop. As a result, the fetus does not receive the full amount of nutrients and oxygen for development.
  • Uterine rupture at the suture from a cesarean section is the most dangerous complication during childbirth. Often, against a background of severe pain, it occurs without significant symptoms. Therefore, during labor, the doctor constantly monitors the condition of the suture, palpating it through the anterior abdominal wall. It should remain smooth and painless. It is important to monitor the amount and nature of bleeding and focus on the complaints of the woman in labor. An unnatural weakening of labor, the appearance of pain in the navel area, nausea or vomiting may indicate a rupture of the uterine body at the seam. Ultrasound examination helps to objectively study the condition of the scar. If a violation of its integrity is confirmed, they urgently switch to surgical delivery.

Is it possible to give birth on your own after two cesareans?

Natural birth after two or more cesarean sections is unlikely due to the high risk of serious consequences, including:

Having undergone a caesarean section during the first birth, women are unconditionally given only a caesarean section during the second and subsequent pregnancies. Indeed, until recently this was a generally accepted practice and other options were not even discussed. After all, the defective scar on the uterus increases with each subsequent pregnancy, and after the third child, sterilization is usually offered.

What options exist today?

However, developed modern medicine is not so categorical regarding caesarean section. For some women, the only option for repeat pregnancy is a cesarean section, but for others, a natural birth is possible and even desirable.

Let's consider situations in which only a caesarean section is possible for the second (and subsequent) births in the case where the first pregnancy was also resolved by caesarean section:

A repeat operation is required when the first cesarean section was scheduled due to the anatomical structure of the expectant mother’s body, which, naturally, has not changed since that time. For example, a narrow pelvis may be an indication for a caesarean section; surgery is also prescribed for deformities or bony protrusions in the pelvis.

Caesarean section is prescribed for high myopia, previous traumatic brain injuries, retinal detachment, that is, for somatic diseases of the woman.

Multiple pregnancies, in most cases, cannot be resolved by natural birth without risking the life of mother and child. Therefore, it is better to prefer a caesarean section.

Repeated surgery is indicated for hypertension and diabetes.

A caesarean section will also be prescribed in a situation where the operation during the first birth was unsuccessful or there were complications, or if the scar on the uterus from the first operation fails.

A repeat cesarean section is often the right decision for a pregnancy that occurred earlier than 1-2 years after the first, or there was an artificial termination between these pregnancies. The reason for this is that abortion thins the scar, and it may become defective.

Consequences of caesarean section

It is also necessary to remember that a repeat caesarean section is a technically more complex operation. The possibility of getting pregnant with a repeat cesarean section decreases and remains only in 40% of women. The reason for this is menstrual dysfunction.

But for women who gave birth to a second child naturally, this percentage is much higher and the ability to conceive is not lost.

Also, with a repeated operation, complications may arise; the bladder, ureters or intestines can be injured. And the adhesive process in the scar area leads to disruption of the normal anatomical interaction of organs.

The risk of developing anemia, endometritis, and thrombophlebitis of the pelvic veins increases significantly with a repeat caesarean section. Also, quite often, with repeated surgery, the possibility of hypotonic bleeding increases, which is almost always impossible to stop using traditional methods. And therefore, such bleeding often leads to removal of the uterus.

And, most importantly, the baby suffers much more during the second and subsequent cesareans than during the first. Much more often, circulatory disorders in the brain of an already born child occur, since during the second operation it takes more time to penetrate the abdominal cavity, which means that the baby is under anesthesia longer. He may also suffer a cervical spine injury or hypoxia if it was difficult to bring him into the light.

Summarizing the above, we can conclude that the second and subsequent cesarean sections should be prescribed only for absolute medical reasons, and not be a method of choice.

With the advent of modern technology, many inaccessible things become possible. Today on the website we will talk about artificial insemination, how childbirth occurs after IVF and whether natural childbirth is possible.

Currently, many couples are faced with the problem of infertility, and it provided them with the opportunity to hear the first cry of their child and feel the joy of parenthood.

Modern IVF

Reproductive technologies are constantly developing: if a few years ago the procedure for artificial insemination was something unusual and caused wariness on the part of others, now the news about a child who was “conceived in a test tube” does not surprise almost anyone.

Childbirth during an IVF pregnancy is no different from childbirth after a natural pregnancy. Although some time ago the attitude towards this process in society was very contradictory. Many people mistakenly believed that with artificial insemination, childbirth should take place somehow differently.

Previously, the expectant mother was implanted with 4-6 embryos and the procedure was considered successful if 1 embryo implanted. Now the effectiveness of the method has increased several times; 1-2 embryos are enough for pregnancy to occur. Moreover, in some cases, hormonal maintenance therapy is not given until 14 weeks.

The need to allow labor through caesarean section has disappeared. Although several years ago, a mother who conceived a child using this method was categorically recommended to undergo surgery. Currently, natural childbirth has become possible after the IVF procedure.

Indications for surgery

For quite a long time, one of the indications for cesarean section was IVF. Natural childbirth is impossible in some cases. There are main indications for:

  • long-term infertility;
  • malposition;
  • woman's age;
  • chronic diseases of the mother;
  • genital herpes during an exacerbation;
  • acute oxygen deficiency in the fetus;
  • neurological diseases;
  • poor vision of the expectant mother (consultation with an ophthalmologist is necessary);
  • gestosis;
  • anatomical features (narrow pelvis, symphysitis);
  • large fruit;
  • IVF complicated by the health status of the mother or child;
  • a history of several abdominal surgeries;
  • repeat IVF, especially if there are complications.

At the moment, many doctors believe that it is necessary to give a woman the opportunity to give birth on her own if she has no health problems.

Independent childbirth

If a woman does not have serious health problems, then it is quite possible to give birth on her own. It all depends on your mood and the doctor’s opinion on this matter. Some experts are confident that natural childbirth after IVF is undesirable (to avoid risks) and insist on surgery.

Having twins is also not a contraindication to natural delivery.

The main conditions under which natural childbirth is possible:

  • successful pregnancy (no complications);
  • woman's age under 35 years;
  • health status of the expectant mother.

All stages of childbirth during IVF (contractions, pushing) are the same as during delivery after a natural pregnancy.

Which birth to choose

Many doctors are of the opinion that it is necessary to give the mother the opportunity to give birth herself, in a natural way.

Which birth to choose after IVF: cesarean or natural, you decide together with your attending physician and obstetrician-gynecologist. Through surgery, it is possible to minimize complications that arise during natural childbirth. But it should be remembered that complications are possible with a caesarean section.

And also with CS, the recovery period and rehabilitation of the mother after surgery increases.

Important to know

The site warns that women who conceive a child through IVF should prepare in advance for childbirth, especially if they are pregnant. Indeed, with multiple pregnancies, as a rule, labor may occur prematurely, several weeks earlier. To do this, you should go to the maternity hospital in advance, two, sometimes three weeks before the PDR, for observation and examination.

In the maternity hospital, the expectant mother is given all the necessary tests, regular fetal CTG and ultrasound are prescribed. Using ultrasound data, the doctor determines the child’s parameters (weight, height), can draw conclusions about whether there is hypoxia, determines the amount of amniotic fluid, and assesses the condition of the placenta.

During IVF pregnancy, the doctor can determine the exact date when the baby will be born.

If a woman has absolute indications for a CS, then after a detailed examination a date for the operation is set.

The recovery of a mother after the birth of a baby conceived through IVF is no different from the rehabilitation of women who became pregnant naturally:

  • milk comes on average 2-3 days after birth;
  • the uterus returns to its original size after 1.5 months and weighs about 50 g;
  • stool and digestion return to normal after 5-7 weeks;
  • spotting () continues for about a month and a half.

Rehabilitation after surgery is somewhat more complicated. The woman is forced to receive antibiotics in the first days after the CS. As a rule, the child is brought in on the third day to stay together. You can't lift weights. To contract the uterus, women in labor are given injections of the hormone oxytocin.

Repeated births after IVF are possible after at least 3 years. A woman needs such a break so that her body recovers and gets stronger.

Whatever method of childbirth you choose, listen to the opinion and recommendations of a specialist. If there are no indications for a cesarean section, it is necessary to prepare for childbirth psychologically and physically in advance in order to minimize possible complications and risks.

The desire to have children is a natural and natural feeling for every woman. And if some dream of at least one toddler, others see their happiness in raising several kids. But it often happens that first children are not easy, and a mother who has undergone surgery wonders: or will each subsequent baby be born only with surgical intervention?

Just a decade ago, a woman would have been categorically answered to such a question that after one operation, all subsequent births are carried out only by caesarean section. This was due to the fact that previously doctors performed the operation in a different way, making a vertical incision in the upper segment of the uterus. Today, doctors perform this operation using a transverse incision in the lower segment of the uterus, which reduces the risk for mother and baby. So: a change in the technique of surgical intervention has made it possible to carry out a natural birth after a cesarean section.

Moreover, doctors not only allow childbirth to be carried out using the natural method, but also insistently recommend. The fact is that the CS itself is a serious abdominal operation that can provoke complications and consequences, such as inflammation, blood loss, etc. In addition, the effect of anesthesia on the body of the expectant mother is a fairly serious risk, which in the worst case can result in anaphylactic shock. In addition, the operation always carries a risk for the baby, since quite often doctors detect malfunctions of the breathing apparatus in children born this way. And finally, lactation. After a natural birth, milk comes in much earlier, and the lactation process improves quickly, but after a cesarean birth, everything takes much longer. All this is an undeniable advantage of natural childbirth!

However, for those who think Is it possible to give birth on your own after a caesarean section?, it is worth knowing about possible complications during a second natural birth.

Possible complications during natural childbirth after cesarean section

The most dangerous and common complication that women who have given birth to their first by cesarean and second naturally may face is: this is a uterine rupture. This pathology may occur due to the fragility of the scar that formed after the first birth. However, in fairness, it is worth noting that there are very few such cases - about 1-2% of the total number of such women in labor. At the same time, American scientists proved 30 years ago that this risk is the same both for those who give birth themselves after a caesarean section, and for those who give birth naturally both times.

The main condition that should be observed by the expectant mother who wants to give birth herself is: survive for at least two years after cesarean section. Moreover, modern doctors “give the go-ahead” for natural childbirth, even if before that there was not one, but two cesarean ones. For this, it is only important that the expectant mother has no contraindications and the correct parameters (including location) of the future baby.

Summarizing what has been said, natural childbirth after the first cesarean section is possible if the following conditions are met:

  • The first cesarean section was performed through a lower transverse uterine incision;
  • There is an interval of at least two years between births;
  • There are no indications for cesarean section;
  • A woman's desire to give birth on her own.

In conclusion, we present statistical data. More than 80% of pregnant women can give birth naturally after a previous caesarean section. So it's up to you!