Is natural birth possible after cesarean section?section? This question worries quite a large number of women whose first child was born by caesarean section. Moreover, most of these women complain that the gynecologist they are seeing stubbornly insists that this time the delivery be carried out by caesarean section. And they motivate their decision very vaguely - because the first pregnancy also ended in caesarean section. Moreover, such a practice is very popular - almost all clinics practice it. Moreover, after the second pregnancy, doctors begin to actively agitate the woman in favor of sterilization. They motivate this recommendation by the fact that the third pregnancy, due to the poor condition of the uterine scar, is very dangerous not only for the life of the fetus, but also for the mother's life. However, in recent years, the views of obstetricians and gynecologists on this problem have changed radically. And, despite the fact that there are still cases when the next birth after a caesarean section should also be carried out by caesarean section, their number has become much less. However, more and more often doctors prefer to give such women the opportunity to give birth to a child naturally - strictly speaking, throughout the entire pregnancy doctors systematically prepare the pregnant woman for natural childbirth.
When is caesarean impossible to avoid?
Before talking about whether natural childbirth is possible after a cesarean section, we need to understand in which cases it is absolutely impossible. Such cases include:
- Anatomical features of a woman
As a rule, most often a repeat cesarean sectionThe section is performed on women who have specific features of the anatomical structure of the body. It is these anatomical features that caused the previous pregnancy to end in a cesarean section. Most often, such anatomical features are a pathologically narrow pelvis of a woman, which does not allow the child to pass through the birth canal. In addition, sometimes there are somatic anatomical features - for example, serious craniocerebral injuries, high myopathy, partial retinal detachment, in a word, all those conditions that exclude the possibility of the pushing period. Unfortunately, these conditions almost never go away even over time, which means that strict indications for a cesarean section remain throughout the woman's reproductive age.
- Multiple pregnancy
Very rarely, but there are still cases whena woman is carrying a multiple pregnancy for the first time, and doctors perform a cesarean section. But the second pregnancy also turns out to be multiple. In this situation, the obstetrician-gynecologist will most likely also make a decision to perform a cesarean section. Firstly, the birth of two or more children puts increased stress on the uterine scar. And secondly, most often children from multiple pregnancies have low weight, so passing through the birth canal can be a very serious test for them.
- Status of uterine cicatrix
Despite the fact that the presence ofThe presence of a cesarean section scar in the uterus should not be a contraindication to natural childbirth, a lot depends on its condition. The doctor must carefully assess the condition of the uterine scar from the previous cesarean section using ultrasound. And only if its condition allows natural childbirth, the doctor will make such a decision. Otherwise, it is unlikely that a cesarean section will be avoided, since natural childbirth can pose a threat to the health and life of the mother and baby. By the way, a lot depends on what kind of scar a woman has - with a longitudinal scar, the only option for delivering subsequent pregnancies is a repeat cesarean section. In addition, if the interval between pregnancies was less than two years, or if the repeated pregnancy was preceded by a miscarriage or artificial termination of pregnancy, the chances of natural childbirth will also be minimal. This is due to the fact that the scar becomes significantly thinner due to surgical curettage.
- Third pregnancy
In the event that this pregnancy is notthe second, and already the third, and the two previous ones ended with a cesarean section, in almost all cases the only possible way to deliver is by cesarean section. Despite the fact that the third cesarean section is much more difficult from a technical point of view than natural childbirth, doctors prefer not to risk either the life of the woman or the life of the baby - the danger for them is too great. In addition, a repeated cesarean section is often accompanied by a number of different complications, unlike the first. Moreover, damage to the bladder and ureters is most common. As a result, an adhesive process develops in the pelvic organs - adhesions affect almost all internal organs. In addition, complications such as thrombophlebitis and anemia often occur. All this makes natural childbirth extremely dangerous for the health and life of the child and the woman.
Repeated cesarean section. Good or evil?
Sometimes women themselves insist on carrying outrepeated cesarean section, fearing pain during natural childbirth. However, in reality, cesarean section surgery, despite the fact that it has been well-developed for decades, still carries certain risks. And it does not have the best effect on the body of a pregnant woman. As a rule, a repeated cesarean section lasts longer than the first. This means that the risk of developing both fetal hypoxia and cerebrovascular accident of the baby increases significantly due to the longer exposure to anesthetic drugs. In addition, a cesarean section is always a certain risk that the cervical spine of the baby may be damaged. In addition, even the most modern methods of anesthesia, such as epidural, still cannot pass without a trace for the woman's body - to a greater or lesser extent, but they have a certain negative effect on the woman's body. It is also important to remember that a caesarean section is an abdominal operation, which means that no one is immune from problems with sutures, sometimes quite serious. That is why doctors - gynecologists and surgeons never tire of repeating in one voice that a caesarean section is a rather serious threat to both the mother and her baby. Therefore, a repeat caesarean section should be resorted to only if there are strict indications for this method of delivery. The doctor must carefully weigh all the pros and cons, the possible risk and the expected benefit - and only then can he make the right decision. After all, the advantage of natural childbirth is obvious - this is the method of birth that nature has provided. And it is unlikely that a person will be able to come up with anything better. And the process of restoring the female body after natural childbirth takes much less time than after a caesarean section. The same applies to breastfeeding - it may take much more time and effort to establish it after a caesarean section than after a natural childbirth.
So what to choose?
So, as we have already found out, the most optimalвариантом для повторного после кесарева сечения родоразрешения являются все же естественные роды. В идеале, подготовка к ним должна начинаться сразу же после появления на свет первого малыша путем кесарева сечения. Первое, что необходимо сделать врачу – это установить, что же именно послужило показанием для проведения первого кесарева сечения. Выше уже описывался ряд случаев, исключающий возможность провести естественное родоразрешение после кесарева сечения. В том же случае, если причиной проведения кесарева сечения послужил сильный поздний токсикоз, отслойка плаценты, либо ее предлежание – у женщины очень велики шансы того, что естественное родоразрешение после кесарева сечения окажутся возможными. Кроме того, еще во время первого кесарева сечения врачи – хирурги должны позаботиться о том, чтобы женщина имела возможность второго своего ребенка родить естественным путем. Для этого очень важно подобрать правильный качественный шовный материал, да и шовной методике необходимо уделить особо пристальное внимание. При выписке из роддома женщине обязательно должна быть выдана на руки выписка, в которой подробным образом будет описан способ родовспоможения, причины, которые вынудили врачей прибегнуть к проведению кесарева сечения, сам ход операции, – какой применялся анестетик, шовный материал и шовная технология. Обязательно сделайте ксерокопию всех этих документов и храните ее дома, со всеми остальными важными документами. Это поможет вам застраховаться от ситуаций с потерей вашей медицинской карты – к сожалению, такое иногда случается. И даже компьютеризация всех поликлиник не сможет полностью исключить такую возможность. При выписке врач подробно объяснит молодой маме, как она должна вести себя во время реабилитационного периода, для того, чтобы избежать возможных осложнений в будущем. И женщина должна неукоснительно соблюдать все рекомендации до единой. Кроме того, ни в коем случае нельзя игнорировать профилактические посещения врачей – гинекологов – эта мера поможет выявить возможные осложнения в самой начальной их стадии. Кроме того, в идеале последующая беременность должна быть планированной. И еще перед беременностью женщина должна заранее посетить врача – гинеколога, а также пройти исследование состояния рубца на матке. Существует две разновидности подобного исследования – гистерография (рентгеновское исследование шва) и гистероскопия (исследования шва при помощи специального зонда). Как правило, подобные исследования целесообразно проводить не ранее, чем через год после кесарева сечения. В том случае, если процесс восстановления организма женщины после родов завершился нормально, при исследовании маточного рубца он практически не визуализируется. Первое, что должен установить врач, производящий исследование – это то, какой именно тип ткани преобладает в сформировавшемся рубце. В идеале эта ткань должна быть мышечной, но не соединительной. Собственного говоря, именно через год, во время исследования рубца на матке уже становится совершенно очевидным его состояние, ведь он к этому моменту является абсолютно сформировавшимся, и вряд ли его состояние глобально изменится. Кстати говоря, именно результаты этих исследований в большинстве случаев и играют решающую роль в принятии врачом решения о возможности проведения естественных родов, а не вторичного кесарева сечения. 
Pregnancy after caesarean section
Many mothers begin to worry aboutcondition of their child from the very day they find out about their pregnancy. Moreover, the most common fear is that the growing uterus will sooner or later burst along its scar. However, these fears are absolutely groundless - the course of the pregnancy following a cesarean section is absolutely no different from that during the previous one. The only condition that a woman must strictly adhere to is early registration at a women's clinic, regular visits to all scheduled examinations by a gynecologist, compliance with all his appointments, recommendations and instructions. It would be very good to find a gynecologist as early as possible who will subsequently deliver the baby. As a rule, this doctor will carefully monitor the condition of the uterine scar throughout the pregnancy, both with the help of an ultrasound examination and with the help of palpation - a manual examination. By the way, if a woman experiences pain during palpation of the uterine scar, she should hardly count on a second birth after a cesarean section in a natural way. However, the final decision on the possibility or, on the contrary, the impossibility of natural childbirth is made by doctors at 35 weeks of pregnancy. The expectant mother will be prescribed an ultrasound examination again, which should confirm the viability of the scar, the correct position of the fetus - longitudinal, as well as cephalic presentation. In addition, placenta previa is very important. If all indicators are normal, and the woman has no other contraindications, doctors will begin to prepare the expectant mother for natural childbirth. In addition, another nuance is very important - how full-term the pregnancy is. Natural childbirth in such a situation can only take place if the pregnancy is full-term - more than 37 weeks, but the baby should not be excessively large - more than 4,000 grams. Otherwise, the risk increases significantly, and most often begins to exceed the expected benefit.
Term of hospitalization in maternity hospital
The question of the term also often arises.hospitalization of a woman in a maternity hospital who plans to have a natural birth after a cesarean section. It is a very common practice for a pregnant woman to be admitted to a maternity hospital in advance, one to two weeks before the expected date of birth. As a rule, the following happens: approximately on the day of the expected date of birth, or a little earlier, doctors puncture the amniotic sac, after which they begin to artificially stimulate the onset of labor. This entire procedure is carried out during the daytime, when all doctors are at their workplaces. Doctors explain their actions by ensuring maximum safety for the mother and baby. However, this practice has not only supporters, but also ardent opponents. They motivate their position by the fact that artificial stimulation of labor has only one danger, a fatal one - rupture of the uterine scar. After all, if artificial stimulation of labor occurs, the cervix opens abruptly and unevenly. In the same case, if labor begins naturally, the opening of the cervix occurs very smoothly, which significantly reduces the load on the uterus itself. During natural childbirth, the risk of the scar bursting unexpectedly is practically zero - any experienced doctor will be able to notice the threat in time and take all necessary measures in this situation. Strictly speaking, all such births should be carried out under triple control and attention to the condition of the woman giving birth. After the placenta has come away, a mandatory condition is a manual examination of the condition of the scar, of course, under general anesthesia.
Effect of childbirth on the child
Despite the fact that recently everythingmore and more obstetricians and gynecologists actively promote natural childbirth after cesarean section, of course, provided that there are no contraindications to this, in reality the situation does not change that much. And, despite the fact that almost all women are ready to go through a longer recovery period after a repeated cesarean section in order to get rid of labor pain, few of them think about how this or that method of birth affects the child. But for a child, childbirth is much more stressful than for its mother, because during the passage of the child through the birth canal, he experiences severe pressure on the bones of the skull. However, during the birth of a child by cesarean section, the stress is incomparably greater than during natural childbirth. After all, during a cesarean section, a child enters the environment extremely abruptly, and not gradually, as it should normally happen. Namely, because of this abrupt birth, the child's body simply does not have time to produce the so-called stress hormone in the required amount. The purpose of this hormone is to facilitate the process of adaptation of the child's body to the environment. That is why almost all children are born by cesarean section. The indicators of all vital processes in such children reach their normal values only by the end of the seventh to tenth week.
Think for yourself, decide for yourself ...
As you may have already seen for yourself, naturalchildbirth is still much better for both mother and baby. However, as mentioned above, there are a number of women who have absolute indications for a cesarean section. For them, the best option that does not threaten the life of the mother and child is a repeat cesarean section. That is why the expectant mother should not give in to advice, persuasion and pressure from anyone - mother, relatives, friends, in a word, all those who are very, very far from medicine. The only person whose opinion the expectant mother should really listen to is the obstetrician-gynecologist. Only a doctor can adequately assess your body condition, the condition of the uterine scar, weigh all the pros and cons of both methods of birth of your baby. And in no case ignore the help of obstetricians-gynecologists. Unfortunately, often, despite the high level of modern medicine, many women recklessly hope for "maybe". This should never be done, as otherwise there is a very high risk of developing various complications. After all, the well-being of your baby depends on you. And remember that, in principle, if you do not manage to give birth in the way you wanted, you should not be too upset. After all, no matter what, your long-awaited baby will not become less loved and happy. So enjoy your baby, without getting upset without special need! We advise you to read:
