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  1. #1

    Risks of having a natural birth after a cesarean birth

    Well I am having my second son in March, but I had a cesarean with my first one. The cord was around is neck, so I was not dilating at the time. I went to the doctor for my checkup and I was told that I would have to have another cesarean, because having a natural birth would not be safe for me or the baby. What I am concerned about it what are the risks of my having a natural birth? Does this mean that I would have to have a rushed cesarean if something happens? Is it just the fact that the baby will not be able to move down?

  2. #2
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    The research shows that vaginal birth after caesarean is a safe option. Currently around one third of women end up with a caesarean - which is absolutely outrageous and unacceptable. A rate of 10 to 15% of caesarean births is what the World Health Organisation safe is an acceptable percentage of caesarean births. Caesareans are frequently done without good medical reasons.

    The cord around a baby's neck (known as a nuchal cord) is a common scape goat when intervention occurs. This is a normal finding in up to one third of all pregnancies and generally doesn't cause any problems at all. There is a wonderful blog post on this called Nuchal Cords: the perfect scapegoat by Midwife Thinking.

    Another reason why we have an unacceptably high caesarean birth rate is what I call "failure to wait". Labour and birth takes time and many in the medical profession fix arbitrary time limits on labour that are not research based. Many women are not even given the time to get into established labour (4cm and beyond). The time it takes to get into established labour various from many hours and occasionally a number of days. Comfort and support is needed if early labour (or prelabour) is prolonged.

    The real risk to a vaginal birth after caesarean is small. The main risk is scar rupture which is less than half of one percent. It is important that the labour is allowed to progress naturally without stimulating it with drugs (this increases the risk of scar rupture).

    With any birth this is a chance a caesarean can occur. Sometimes a caesarean is needed quickly and there can be a rush to get to the operating theatre, however mostly it can be arranged in a timely fashion even for women planning a vaginal birth after caesarean.

    A cord around the baby's neck generally will not prevent your baby moving into your pelvis.
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  3. #3
    Oh ok thank you, I know like the day before that the doctor was saying that my cervix was still small and that I was not dilating at all. I was over due actually on my pregnancy term. Really at that time I did not really know too much of what was going on. Thank you for the advice and the link as well.

  4. #4
    I've had two babies with nuchal cords and witnessed many other births, all vaginal. I am sorry for your experience not turning out the way you would like Lucky120. Have you considered getting a second opinion from another OB or midwife?

  5. #5
    Hi Lucky120,

    You posted on another thread that you wish you could have a natural birth. I was just wondering how strong that desire is.

    I see you're in California and I'm somewhat familiar with California insurance and birth options as we had our first child with a midwife at home, but our insurance was Kaiser (HMO) so I learned how to use both during the pregnancy, to my advantage.

    I'm happy to help you do some research and find the best doctor/midwife for you if you strongly feel that you really want to try for a natural and possibly birthing centre or home birth option.

    Just because your first baby's cord was wrapped around the neck doesn't mean that your chances of the same thing happening again are high. Cords around the neck are very common and a good midwife or doctor will be skilled in handling them.

    When I had my first child, I was told that most midwife's C-Section rate is 3.5 percent (that's under 4%) and, of course that would be for a transfer, because the midwife doesn't actually do the C-Section surgery. Compare that to a 33% C-Section rate (mentioned by Jane) and you can see the huge benefits to having a skilled midwife attending your birth, whether at home, at a Birthing Centre or in the hospital.

    If you want help in having the best birth possible this time around just ask. It's not uncommon for a mom to switch doctors or providers in her 8th month and it can be to your and your baby's advantage.

    Warm regards,

    Kate

  6. #6
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    if you are really wanting a natural birth, research the pros & cons. both vbac & c/section have risks. People forget that a c/section is still major surgery.
    Do your research & ask questions. If you don't ask you'll never know. sometimes c/sections are the best choice but would'nt it be better to make an informed decision about YOUR birth & YOUR child instead of being a passive bystander.

  7. #7
    Lucky120, I agree that you should definitely do research for yourself. If you have a strong desire to have a vaginal birth, you may want to switch to a more receptive care provider. I have had two babies with a cord around their neck, both uncomplicated vaginal deliveries. I have also witnessed it with other labouring mothers. It is not uncommon and would not stop you from dilating.

  8. #8
    ''The research shows that vaginal birth after caesarean is a safe option. ''

    Would like to share my experience. VBAC was not a safe option for me.

    I had a planned c-section but went into labour naturally the day before and progressed without any stimulating drugs (had an epidural when I got to 7cm). Labour progressed well so I thought yipee have gone into labour by myself so I can have a VBAC which I did achieve but not without drama. My uterus ruptured at 10cm. My daughter was born with forceps then I was straight into theatre the first of three times that day. I had a hysterectomy and my bladder also ruptured. I had multiple blood transfusions. I was sedated overnight and in ICU for 3 days. Yes I AM very lucky to be alive.

    I hope my experience helps you make the right decision for you.

  9. #9
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    Welcome Murraylou to our forum. I am so sorry you had a very traumatic experience. I cannot imagine how you must feel about what happened and how it has affected your family. How was your daughter? Did the hospital provide support and counselling? Was there any signs in your labour that something was wrong prior to your uterus rupturing?

    Unfortunately birth sometimes doesn't go to plan and an unexpected outcome can occur even using the best research evidence along with the best care offered by health professionals and/or the hospital. I had an experience as a midwife many years ago when a woman came into a hospital I was working at for her planned third caesarean at full term. We chatted and got along really well. We went of to the operating theatre for her caesarean. During the routine procedure her baby was born flat and not breathing and then she started to haemorrhage profusely. Due to the adhesions (bands of scar tissue that forms after a previous caesarean) that had stuck to internal organs - the surgery was difficult and she lost many litres of blood, her uterus but thankfully not her life. Her baby - who had not been stimulated by labour to breath - took a turn for the worst and almost lost his life as well. Both mother and baby did recover. It was however a very traumatic experience.

    If there is any thing we can do for you to provide support Murraylou - please let us know.
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  10. #10
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    I had a successful VBAC at home in January this year. There were no issues from my previous c/s during or after the birth (which was exciting for me but uneventful from a medical point of view!).

    I hope you also have a good birth next month and are able to get the care and support you need.

  11. #11
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    Hi Lucky120,

    Wishing you all the best for your upcoming labor and birth. I supported a beautiful VBAC last weekend (was their second son also) and it was such a positive experience for the lady and her partner who had an emergency c-section for the birth of their first son. Everything went smoothly and as she birthed in the birth centre, no additional pressures or restrictions were placed on her even though she was a VBAC Muma.

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