Natural Childbirth After Cesarean Section

Natural Childbirth After Cesarean Section
Natural Childbirth After Cesarean Section

Nowadays Cesarian section is a quite common way to deliver a child. The doctors are doing their best to ease the childbirth process via cesarean in more than 30% of all pregnancy cases in developed countries. Unfortunately, due to the tendencies of the modern world many women have the so-called “weak labor” – a lower physical activity of the mother, bad habits, obesity, horizontal birth and the elder age contribute. But the woman once subjected to giving birth via Cesarean is not condemned to the repeated c-section in her subsequent pregnancies.

As you know, caesarean section (Latin Caesarea “royal” and section “cut”.) – is the delivery operation in which a newborn is removed from the womb through an incision in the uterus. Means that the tissues of the uterus partially lose the elasticity in the place of the cut, where the dense tripe is formed.

Many specialists nowadays encourage women to give natural childbirth even considering the prior experience of cesarean section.

I started my work with pregnant at the time when women who gave birth by cesarean section once were strictly forbidden to give birth naturally. “Not recommended” were the words they were actually using, but generally, it was a sentence if a woman needed medical assistance in her delivery. It was hard to prohibit natural childbirth after caesarean section at all because some of the deliveries still happened without the observance of the specialists. The birth of a child is still very personal, and even a doctor with the best intentions shouldn’t interfere in private lives of a family.

When is it possible to give birth after c-section?

In order to understand whether a woman with uterine scar may go through the vaginal childbirth, you need to figure out the reasons for the prior caesarean section. Indications may have been different and some of them could also affect the following genera. For example, an anatomical narrowing of the pelvis, bone deformation, and projections in the pelvis. Somatopathy in women – craniocerebral trauma, high myopia, retinal detachment may also be the contraindications. With these violations and deviations re-operation is inevitable. But there are indications for a cesarean section that may not recur in subsequent pregnancies: placenta previa (when the placenta covers the internal os of the uterus), twins or breach position of the fetus. Another common reason for surgery – uterine inertia. It is sometimes repeated, but can be successfully corrected, because the body has already gained experience of motherhood. In these cases, doctors at discharging the woman from the hospital say that the next pregnancy will not necessarily end by Caesarean section and she will probably be able to give natural birth.

The story about natural childbirth after caesarean section

pregnant womenWe’ve just started the first year of obstetrics. Classes were held in the old maternity hospital of our city. End of November, the weather outdoors was -38 Celsius, and the temperature in the premises of the old building was only +12! The classes started at 9:00 am. And here we were, by this wearing the cotton shirts and robes, shivering from the cold in the classroom. The teacher comes in and says, “You are lucky – the first day of the year, and you will take part in real childbirth! An interesting case of childbirth, I must say! Come with me!”.  On the way the doctor told us briefly that a woman in labor came to the hospital half an hour ago, cervical dilatation almost full. At that moment, she was already in the patrimonial – contractions started. But the complexity of this situation lied in the fact that just a year before that woman had a cesarean section. If she had come a little earlier, with little cervical dilatation, an emergency cesarean section would have been inevitable.

And this woman is in front of us! We were in a patrimonial for the first time and saw the birth of a child for the first time. Only one of us is a mother, the other ten girls are twenty years old, still unmarried and nulliparous. Later, I often thought about how she felt in +12 C′, surrounded by a crowd of students, but at that moment, I felt just tension and fear thicken around us. Not only the interns but also the doctors and midwives were there in the labor ward: “How could she take such a risk? She was told not to get pregnant for three years, what has she done… Lord have mercy!”. Some were praying, some were shouting and at the same time, everything was ready for the emergency operation. The doctor and the midwife, leading the childbirth, were concentrated on guiding mother’s actions.

And there he was, in front of us – a baby, delivered from the womb! A boy! A real hero! He was 4200 g.! And the mother got no! Neither outside nor inside. The uterus, the cervix, the vagina, and the perineum – everything remained whole!

It is necessary to admit that there, in a labor ward, I nearly fainted! The person who had never trembled neither in a morgue surrounded by corpses nor in operational where we were shown the most difficult and bloody surgeries. But the thought of the risks the woman had taken and the prejudice made the whole picture stressful and emotional. And it was the first time I saw the birth of a human being. And that was like a blessing and a relief – a guiding star in my future work.

I am very grateful to that woman because thanks to her I gained the confidence that my childbirth will be fine.

I think this is how the life goes – people transmit their faith, strength, and love to the others, younger and less experienced, and they, in turn, support those, who follow.

The Risks

pregnant womenLater, in 80-es the Сesarean section was not a sentence anymore! In many countries, the first cesarean section was not contradicting the natural childbirth at all. I examined scientific research cases, which confirmed that risk of uterine rupture (the biggest fear of obstetricians and gynecologists of the past) in modern surgical practice is almost brought to naught. In addition, the ultrasound has become available, which makes it possible to monitor the uterine scar during the whole pregnancy. Thus, the attitude towards natural birth after the Caesarean section has slowly changed. Now it appears that natural childbirth after Cesarean section is not only possible but is a better option for your health and the health of the baby.

Psychological issues

And still there is a problem! The mental one. At training women who decide to go through vaginal (natural) childbirth after Cesarean section it became clear that every story is unique, but nevertheless, it is possible to track some general tendencies. More often it happens so that a pregnant woman has one or more of the following problems with the different degree of complexity.

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Believing in success

First, and it’s clear in this situation that the first unfortunate experience hinders a lot to all women: “I could not last time and I will hardly be able to do it next time!”. In this case, a thorough analysis of the previous pregnancy and childbirth helps. I remember one of my patients saying about her first pregnancy:

“In general, I hardly felt like a pregnant woman: first, it wasn’t a great pleasure, because the child’s father wasn’t going to marry me at all, second, before the childbirth I had to work as a slave and this fact pleased my boss very much. Even in labow ward I was engaged in booking the plane tickets for him and after the operation I was reserving a hotel”.

And here is the other woman’s story about childbirth:

 “I came to the maternity hospital with contractions late in the evening. It turned out that cervix dilated for 2 cm. I was offered to have a rest and they gave me an injection, after which I felt asleep. By the morning I was awakened. I was in labor and the doctors started to stimulate the chidbirth. But the contractions didn’t start, and by the noon I was operated.”

After analyzing the reasons of the necessary of a cesarean section, it worth thinking about how to prevent this scenario in future. Sometimes it happens so that it isn’t possible to find the visible reasons of failure of childbirth process, but nevertheless, in most cases the reasons are obvious.

Responsibility for childbirth result

newbornMany women feel offended and angry with the doctors for several years. These women tend to shift responsibilities for the childbirth to medical staff: “They were taught to do it! And I didn’t know anything about the job! ”. I think it’s very important, and at the same time, very difficult – to take your responsibility. “Yes, I was very hurt by the man who left me alone, but I still had parents and friends, whom I could trust. However I chose an escape into work and was poorly involved in my pregnancy.” “Yes, the doctors gave me an injection, but I didn’t even ask what was it for and what will happen if I refuse. In fact, I wanted to sleep, and I was glad that I could relax.”

A woman and femininity

Many women have low self-esteem, especially in matters of femininity, or they don’t consider femininity a special value. This doesn’t mean that these women are similar to men, not at all! Each of us has both male and female because we are all born from the love of man and woman. In fact, living in a modern society, it’s essential for a woman to have masculine qualities, because they allow maintaining enormous loads, reaching for their goal, and achieving it. Whereas feminine qualities that are responsible for the ability to wait, to take what’s offered, to endure, are as important to live, but if I may say so, are not fashionable in the modern world. As a result, women deny those feminine characteristics, preferring to cultivate those masculine. Trying to be beautiful, they still look sexy but not feminine, while feminine and sexy are not the same thing. Will the woman who is going to prepare herself for a natural childbirth want to look at herself from this side? Not really. And I understand why: many women have the similar problems in many ways. All this makes the Cesarean section one of the most “popular” operations in childbirth.

Emotional dependence on the mother

A large percentage of the C-sectioned women have either not so good relationships with their mothers, or depend on them emotionally. What does the mother say about her pregnancy and childbirth? How many children does she have? Does mother breastfed her daughter? What kind of relationships had they during adolescence of the daughter? How did mother explain the changes of the body, periods, pregnancy and childbirth? What kind of relationships mother and daughter has during the first pregnancy of the daughter? What does the mother think about cesarean section?
I remember a woman who confessed to me:

“I had my first childbirth five years ago. The vaginal birth had complications and after a couple of hours ended with cesarean section. My mother still doesn’t know. She was so afraid that in childbirth something terrible would happened to me so I told her that everything went perfect!”.

This woman came to me to talk about the option of natural childbirth after caesarean section. During the consultation, we were talking about how much she depends on her mother’s fears and superstitions, and the reasons she hides the facts about her childbirth from the mother. In other words, her mother had serious doubts about the ability of her daughter to become the mother of the own child. The “umbilical cord” of the worrying mother had not been cut. I could give a great number of examples of the mother and daughter relationships inexhaustible topic. But my main goal – is to convey the idea that only a woman who was born by her mother easily and happily can actually bear and give birth to a child easily, happily, and without too much effort. The others will have to work hard!

guiltIn conclusion:

Vaginal childbirth after caesarean section worth a try! If you want to have a vaginal (natural) childbirth after cesarean section, you will have to be persistent. Not every hospital is ready for this type of deliveries as planned. Another thing is when a woman with a uterine scar comes to the emergency department in labors. When her water broke, the condition of the birth canal is good and the dynamics of the opening of the cervix is normal, and the fetus is rather small, doctors can offer a woman to give birth naturally. But even in this case, they would recommend that it will be safer to go through the Cesarean. Such deliveries are still a gimmick to mass hospitals. Only 30% of pregnant women with uterine scars give natural birth after cesarean section. So look for “your” hospital and “your” doctor, who would cheer your up to give birth the way nature has designed it.

Study your condition, contraindications, take a couple of years of rest before the pregnancy and with the right help and assistance go for the natural childbirth without a doubt.

Good health and good luck to you!

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