Normal delivery after cesarean, when possible?
Many people think that once a cesarean delivery is made, every subsequent pregnancy requires a cesarean. According to the guidelines of the Royal College of Obstetricians and Gynecologists (RCOG) in England, 75-80 percent of mothers who undergo cesarean delivery are suitable for normal vaginal delivery in later pregnancy. Of these, 60-80 percent of mothers have a successful normal vaginal delivery without any problems. But before giving a delivery trial, you have to check which mother is suitable for this delivery. For this, some information about the previous seizure should be taken. For example-
Number of previous Caesareans
Those who have had a previous cesarean can only attempt a vaginal delivery in the next pregnancy.
What caused the cesarean?
Seizures occur for reasons that are less likely to recur, such as when the seizure is due to an abnormal position of the baby or because of a problem with the baby or the mother that is not present in the current pregnancy.
How strong is Caesar's position before?
Lower uterine caesarean section or LUCS (stitches in the lower part of the uterus) only allows for a subsequent vaginal delivery trial, with a 0.5 percent chance of the previous sutures rupturing. On the other hand, in case of classical Caesarean section, the suture rupture rate is 1.5 percent. There should be a gap of at least two years between two pregnancies, which strengthens the previous suture site. Placenta previa in a previous pregnancy or infection after a cesarean weakens the suture site, increasing the risk of rupture later. Besides, if the mother has any other complications in the current pregnancy such as high blood pressure or diabetes, she is not considered suitable for normal vaginal delivery trial. A vaginal delivery is also a prerequisite for the baby weighing less than four kg and the birth canal being wide enough. If everything goes well, the pros and cons of this delivery should be informed to the mother and parents. Delivery should be trialed in a hospital where emergency caesarean section can be arranged quickly. Close monitoring of the baby and mother is important in this case. In developed countries, the baby is continuously monitored during labor with a CTG (cardio-tomograph) machine. In 20 to 50 percent of cases, vaginal delivery is not possible and an emergency cesarean is required. Without proper monitoring during this delivery, the rate of complications for mother and baby increases. On the other hand, through successful vaginal delivery, additional surgery on the body can be avoided. As the number of surgical incisions in the body increases, the potential for tissue adhesion and tissue injury increases, and this delivery is free of all surgical risks. But such delivery becomes risky in most hospitals, due to lack of skilled manpower, inadequate equipment for mother and baby monitoring and reluctance and fear of mothers to vaginal delivery.
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