Vaginal Birth After Cesarean Birth

If you have had a cesarean birth with a previous pregnancy, you will need to discuss with the staff the various options available to you with this pregnancy. The options depend on several factors, but the most important are the reason or reasons for the first cesarean birth. If the reason is not clear to you, be sure to ask any questions you may have so that your knowledge of the circumstances surrounding your previous delivery will be complete.

If the reason for the cesarean birth no longer exists (i.e., breech presentation, placenta previa), you may elect a vaginal birth. Remember - there are some conditions such as a small pelvis or a previous uterine incision, one that goes up and down, that do not change. These conditions require a repeat cesarean section.

Lansing OB/GYN Associates has adopted the following policy regarding vaginal birth after cesarean birth: If not precluded for medical reasons, a vaginal birth after a previous cesarean section is four times safer than a repeat cesarean section. This includes the slight and unpredictable risk of uterine scar rupture shown in most studies, but assumes you will labor in the hospital with monitoring available.

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We have looked carefully at the benefits of a vaginal birth over a cesarean delivery and feel that a vaginal birth affords a more rapid recovery time as evidenced by less fatigue and a smoother, more rapid return to pre-delivery activity level. There is no disputing the economic gains of vaginal birth over cesarean; the length of hospital stay is shorter and total hospital costs are reduced because of the decreased use of special environments, like operating suites.

It is, therefore, the policy of this practice and the recommendation of the American College of Obstetricians and Gynecologists that after a careful review of a mother's previous obstetrical history, a vaginal delivery may be elected. The mother and her physician will jointly make the decision to experience a trial labor and attempt a vaginal birth.

Note: This information applies only to Lansing OB/GYN Associates.