First birth with cesarean. And the second?

Is it possible to have a natural birth after one or more caesarean sections?

If you have given birth to your first child with a caesarean section, with the second child it is not said that you have to repeat the experience, but you can instead try the natural ways. "You can do the so-called trial labor, trying to deliver the baby vaginally "explains Stefano Bianchi, director of the gynecology and obstetrics unit of the San Giuseppe Hospital in our city.

In this case we speak of VBAC, acronym of the English expression Vaginal Birth After Cesarean ('natural birth after caesarean').

Statistics say that out of 10 women who attempt to give birth spontaneously after a cesarean, 6-8 make it.

However, the candidates must be carefully selected: if the conditions that led to the first operation still exist or occur again, the use of a scalpel is inevitable. Otherwise you risk an emergency cesarean which could be even more problematic.

Trial labor, for example, is not recommended when the first cesarean was due to a very small pelvis, if complications occurred during the first cesarean, such as a serious infection that may have resulted in imperfect scarring of the wound.

No to VBAC even if, in the new pregnancy, the fetus is too large or presents itself as breech or it is a question of twins.

Rupture of the uterus: a low risk, but possible

Unexpected events may occur during trial labor that require a new caesarean section. The most feared is the rupture of the uterus: in the area of ​​the scar the tissue, being less elastic, cannot resist the efforts of contractions and can give way: this is an emergency situation with serious consequences for the mother and the baby. It can in fact cause profuse bleeding and require blood transfusions or, in extreme cases, the removal of the uterus.

Better a second level hospital

Rupture of the uterus is a very infrequent occurrence (it can happen in less than 1% of cases), but if you intend to give birth vaginally after a cesarean, it is advisable to contact a high-level center that guarantees optimal assistance, where for example there is one immediate availability of blood (which not in all hospitals there is!), a surgical team and an anesthetist present 24 hours a day, an operating room always available.


This makes it clear why doctors themselves often recommend a second caesarean, especially if they operate in small birth points.


Sources for this article: Guidelines on Caesarean section of the Higher Institute of Health; advice from Stefano Bianchi, director of the gynecology and obstetrics unit of the San Giuseppe Hospital in our city.



Newborns immortalized within seconds of birth (PHOTO)

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Born with a caesarean or natural birth. Immortalized within seconds, minutes after their birth. They are the newborns protagonists of these strong but exciting images.

Updated on 02.03.2022

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