Planned caesarean delivery may be the safest option for women who have had a caesarean section in the past, according to a new study by PLoS Medicine.
The experience of vaginal birth has been associated with a small but increased chance of complications for the mother and baby compared to repeated caesarean sections.
The results come from more than 74,000 births in Scotland.
Experts say that mothers should be offered the choice of how to give birth ̵
A recent investigation into Victoria Derbyshire's program suggests that this does not always happen, with many women asking for a caesarean section to be denied.
What is Caesarean Birth?
Caesarean sections are when a baby is born, making a surgical incision in the abdomen and womb.
They can be:
- elective or planned – at the request of the mother or for medical reasons, such as that the baby is either in the wrong position or a very large
- emergency – usually due to complications during birth
More than one in four births in the United Kingdom are from Caesarean section. Half of them are planned or elective and half are urgent.
Which is safer – natural or caesarean?
Birth carries risk, regardless of the way it is done.
Studies conducted in Scotland compared the risks of planned or elective caesarean section with vaginal birth (in women who had a caesarean section in the past) and found:
- 45,579 women gave birth through planned caesarean section and 28,664 attempts for vaginal birth
- 28.4% of those trying for vaginal birth continue urgent caesarean section
- trying for a vaginal birth is associated with an increased risk of the mother having serious birth and postpartum problems compared to the choice for another Caesar's felling we
- 1.8% of those trying for a vaginal birth and 0.8% of those who have a planned caesarean section had serious complications with the mother, such as a rupture of the womb, bleeding or infection
- occurred in 8% of pregnancies with vaginal birth experience and 6.4% of planned caesarean delivery
According to the Royal College of Obstetricians, in most cases women can safely be offered either, as the associated risks will be low. .
In general, after one caesarean section, about three in four women who are naturally born give birth vaginally, while one in four ends up needing an emergency caesarean section.
An urgent caesarean section has a higher risk than planned, which women need to be aware of.
Pros and Cons
Cesarean section recovery can take longer and there is a risk of infection and bleeding from surgery. Each cesarean section has more signs, which increases the chance of the placenta to grow into a scar during future pregnancy and cause complications.
There are also small risks for a baby with caesarean delivery, which include temporary breathing difficulties and accidental delivery (which occurs with about two in every 100 babies, but usually treated without further damage).
The birth of a vagina can mean a shorter hospital stay, faster recovery and return to day-to-day activities such as driving and avoiding the risks of surgery.
But sometimes it can break the perineum – the skin between the vagina and the anus.
In addition, in women who have undergone a previous caesarean section:
- a vaginal birth can put strain on the caesarean scar, which can be separated or torn. This happens to about one in every 200 women
- The serious risk of having a baby, such as a brain injury or stillbirth, is higher with vaginal birth than with a planned caesarean section
Vaginal birth is not recommended if one woman had three or more previous caesarean sections, the guidelines say.
Dr. Pat O & # 39; Brian, an obstetrician consultant and spokesman for the Royal College of Obstetric Gynecologists, said the new study provides useful information to inform women and clinicians as they discuss and make decisions about childbirth. plans.
He said: "Women can be sure that in most cases it is possible and safe to have a vaginal birth or a planned caesarean delivery after a previous caesarean delivery.
“A detailed conversation with the woman and her senior obstetrician must be conducted in order to make an informed choice about the safest way in which she can plan to give birth and be supported by a team of specialists. "