$Unique_ID{BRK00213}
$Pretitle{}
$Title{Can You Have a Normal Delivery After a Cesarean Section?}
$Subject{delivery cesarean Pregnancy Childbirth Vaginal birth VBAC incision
incisions uterus vertical rupture vaginal delivery obstetricians horizontal
small pelvis rupturing fetal deaths fetus birth birthing}
$Volume{K-14}
$Log{}

Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Can You Have a Normal Delivery After a Cesarean Section?


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QUESTION:  You do well discussing controversial medical matters.  Try this
one.  Can you have a normal delivery after you've had a cesarean section?

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ANSWER:  Thanks for your nice compliment.  Here goes.  The saying used to be
"Once a cesarean, always a cesarean," but that's no longer so.  Vaginal birth
after a cesarean section (also known as VBAC) is a reality and is one way to
help reduce the huge percentage of cesarean sections (22.7% of all deliveries
in 1985) in this country.
     VBAC is possible because the method of performing a cesarean has changed.
Up until a few years ago, a cesarean incision on the uterus was vertical, an
incision that was more likely to rupture if vaginal delivery was attempted.
Now obstetricians use a lower horizontal incision that is less likely to
rupture in a later vaginal delivery.
     However (there is always a however, isn't there?), VBAC isn't for
everyone.  A woman who had a vertical incision during her previous cesarean is
not eligible for VBAC, nor is a woman for whom there is no record of the
nature of the incision previously used.  Eligibility for VBAC also depends on
whether the reason for the previous cesarean, such as a medical condition or a
too small pelvis, still exists.  The main danger of VBAC is the uterus
rupturing, which can kill the fetus.  A study of 5,000 VBAC deliveries from
1950 to 1980, which included women who had vertical incisions, found 14 fetal
deaths due to rupture.  Another study of more than 2,000 women with horizontal
scars reported no fetal deaths.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.