Monday, December 2, 2013

"Once a C-section, ALWAYS a C-section"

Is there any truth to this common misconception about labor and delivery?

In short, no. And here's why:

Routine "Repeat Cesarean Section" (RCS) came into practice in the early 1900s because back then. cesareans were done in a vertical cut. This cut is much more prone to rupture, so cesareans became the norm for every mother who had already previously delivered by cesarean in order to prevent rupture during labor.

Today, most c-sections are done with a "bikini-cut", which is a low, horizontal cut on or along the bikini line. It is much less vulnerable to rupture or "unsealing" during labor. The World Health Organization actually declared over 20 years ago that "there is no evidence that cesareans are required after a previous transverse low segment c-section cut".

So what is your option after a cesarean, if not another? Certainly, there is a time and place for RCS, but usually, a safer alternative is VBAC, or Vaginal Birth after Cesarean.

Success of VBAC depends upon:
*reasons for previous c-sections
*arriving at the hospital as late into labor as possible
*not having continuous fetal monitoring
*epidural as late as possible into the labor, if at all
*no induction or acceleration
*previous vaginal birth
*being able to eat, drink and move in labor
*no time restraints
*good relationship with your care providers
*the use of midwives

In the next two posts, I will go deeper into the success factors listed above so there is a better understanding of each and why they are important for the success of a VBAC.

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