Is natural delivery possible after cesarean?section? This issue is concerned about a fairly large number of women, whose first child was born with the help of caesarean section. And most of these women complain that the doctor - gynecologist, whom they observe, persistently insists that this time also the delivery was carried out with the help of cesarean section. And they motivate their decision very vague - because the first pregnancy ended with caesarean section. And this practice is very popular - almost all clinics are practicing it. Moreover, after the second pregnancy, doctors start actively agitating a 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 maternal life. However, in recent years, the views of obstetricians - gynecologists on this problem have radically changed. And, in spite of the fact that there are still cases when the following births after cesarean section should also be performed by cesarean section, they 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, during the entire period of pregnancy, doctors systematically prepare a pregnant woman for natural childbirth.
When is caesarean impossible to avoid?
Before we talk about whether births are possible naturally after cesarean section, it is necessary to understand in which cases this is absolutely impossible. Such cases include:
- Anatomical features of a woman
As a rule, most often re-cesareanThe section is made for those women who have specific features of the anatomical structure of the body. It is these anatomical features that caused the previous pregnancy to end with Caesarean section. Most often, such anatomical features are the pathologically narrow pelvis of a woman who does not allow the child to pass through the birth canal. In addition, sometimes there are somatic anatomical features - for example, severe craniocerebral trauma, high degree of myopathy, partial retinal detachment, in a word, all those conditions that exclude the possibility of an exaggerated period. Unfortunately, these conditions almost never pass even over time, which means that strict indications for cesarean section remain throughout the reproductive age of the woman.
- Multiple pregnancy
Very rarely, but still there are cases whena woman is pregnant with multiple pregnancies for the first time, and doctors perform delivery by caesarean section. But repeated pregnancy also proves to be prolific. In this situation, the obstetrician-gynecologist, most likely, is also an example of a decision to conduct a cesarean section. First, the birth of two or more children exerts an increased burden on the uterine scar. And secondly, most children from multiple pregnancies have a small 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 on the uterus itselfcicatricial cicatrices should not be a contraindication to natural delivery, very much depends on his condition. The doctor with ultrasound should carefully evaluate the status of the uterine cicatrix from the previous cesarean section. And only in the event that his condition allows you to give birth in a natural way, the doctor will make such a decision. Otherwise, it will be impossible to avoid caesarean section, as natural birth can become a threat to the health and life of mother and baby. By the way, a lot depends on what kind of scar in a woman - with a longitudinal scar, the only option for delivery of subsequent pregnancies is a second cesarean section. In addition, if the interval between pregnancies is less than two years, or if a second pregnancy is preceded by miscarriage, or an artificial termination of pregnancy, the chances of natural delivery will also be minimal. This is due to the fact that the scar due to surgical curettage is significantly thinner.
- Third pregnancy
In the event that this pregnancy is not the second,and already the third, and the two previous ones ended with Caesarean section, in almost all cases the only possible way is delivery with the help of caesarean section. Despite the fact that the third caesarean section is much more complicated from a technical point of view than the natural birth, doctors prefer not to risk the life of a woman or the life of a crumb - the danger to them is too great. In addition, a second cesarean section is often accompanied by a number of different complications, in contrast to the first. And most often there are injuries of the bladder and ureters. As a result, the adhesion process develops in the pelvic organs - spikes affect almost all internal organs. In addition, often there are complications such as thrombophlebitis, anemia. 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 insist on holdingrepeated caesarean section, fearing pain in the process of natural delivery. However, in fact, the operation of cesarean section, despite the fact that it has been well worked out for decades, still carries certain risks. And it does not influence the organism of a pregnant woman in the best way. As a rule, the repeated cesarean section in time lasts longer than the first. This means that the risk of developing both fetal hypoxia and cerebral blood circulation disorders is significantly increased, due to a longer exposure to anesthetic drugs. In addition, a cesarean section is always a certain proportion of the risk that the cervical spine can be damaged. In addition, even the most modern methods of anesthesia, for example, such as epidural, still can not pass without leaving a trace for the body of a woman - to a greater or lesser extent, but they have a certain negative impact on the woman's body. We can not forget that the cesarean section is a caval operation, which means that problems with seams, sometimes very serious, are also not insured. That is why doctors - gynecologists and surgeons do not tire of repeating in one voice that caesarean section is a serious enough threat for both mother and her baby. Therefore, to repeat cesarean section should be resorted only if there are strict indications for a similar method of delivery. The doctor should carefully weigh the pros and cons, the possible risks and the expected benefits - and only after that can make the right decision. After all, the advantage of natural births is obvious - this is the way birth was envisaged by nature. And hardly a person can think of anything better. And the process of restoring the female body after natural delivery takes much less time than after cesarean section. The same applies to breastfeeding - for its adjustment after cesarean section, it may take much more time and effort than after natural delivery.
So what to choose?
So, as we have already explained, the most optimalan option for repeated after cesarean delivery is still a natural birth. Ideally, the preparation for them should begin immediately after the birth of the first baby by caesarean section. The first thing a doctor needs to do is to establish what exactly served as an indication for the first cesarean section. We have already described a number of cases that exclude the possibility of performing a natural delivery after a cesarean section. In the same case, if the cause of the caesarean section was a strong late toxicosis, abruption of the placenta, or her presentation - the woman has very great chances that the natural delivery after cesarean section will be possible. In addition, even during the first caesarean section, surgeons should take care of the woman to have the opportunity of her second child to give birth naturally. To do this, it is very important to choose the right quality suture material, and the suture technique needs to be paid special attention. When discharging from the hospital, the woman must be given an extract in her hand, in which the method of obstetrics will be described in detail, the reasons that forced the doctors to resort to the cesarean section, the course of the operation, which anesthetic, suture material and seam technology was used. Be sure to make a photocopy of all these documents and keep it at home, with all the other important documents. This will help you to hedge against situations with the loss of your medical card - unfortunately, this sometimes happens. And even the computerization of all polyclinics can not completely exclude such an opportunity. At discharge, the doctor will explain in detail to the young mother how she should behave during the rehabilitation period, in order to avoid possible complications in the future. And a woman must strictly follow all the recommendations to one. In addition, in no case can we ignore the preventive visits of doctors - gynecologists - this measure will help to identify possible complications in their very initial stage. In addition, ideally the subsequent pregnancy should be planned. And before pregnancy, a woman should visit a doctor in advance - a gynecologist, as well as undergo an examination of the condition of the scar on the uterus. There are two varieties of such a study - hysterography (X-ray study of the seam) and hysteroscopy (seam studies using a special probe). As a rule, such studies should be carried out not earlier than a year after cesarean section. In the event that the process of restoring the body of a woman after childbirth has ended normally, when examining the uterine scar it is practically not visualized. The first thing that the doctor doing the research should establish is what type of tissue predominates in the formed scar. Ideally, this tissue should be muscular, but not connective. Properly speaking, it is exactly one year later, during the examination of the scar on the uterus, his condition is becoming quite obvious, as he is absolutely formed by this moment, and his condition is unlikely to change globally. Incidentally, it is the results of these studies that in most cases play a decisive role in the decision of the doctor about the possibility of performing natural births, rather than the secondary cesarean section. 
Pregnancy after caesarean section
Many mothers begin to worry because of the conditionYour child from that day, as soon as they find out about their pregnancy. And the most common fear is that the growing uterus is too early or, later, it will burst on its scar. However, these fears are absolutely groundless - the course of the next after the cesarean section of pregnancy is absolutely no different from that during the previous one. The only condition that a woman must strictly observe is an early registration with a female consultation, a regular visit to all scheduled examinations of a gynecologist, the fulfillment of all of his appointments, recommendations and directions. It would be very good to find a doctor as soon as possible - a gynecologist, who will subsequently take delivery. As a rule, it is this doctor who will carefully monitor the status of the uterine scar throughout pregnancy, both with the help of ultrasound and with the help of palpation - manual research. By the way, if a woman experiences painful sensations during palpation of the uterine cicatrix, she should hardly be counted on the second birth after cesarean section in a natural way. However, the final decision on the possibility or, on the contrary, the impossibility of natural delivery, doctors take at 35 weeks of pregnancy. The next mom will be given an ultrasound scan again, which should confirm the consistency of the scar, the correct position of the fetus is longitudinal, and also the head presentation. In addition, very important placenta praevia. In the event that all the indicators are normal, and there are no other contraindications to the woman - the doctors will begin to prepare the future mother for natural childbirth. Besides, one more nuance is very important - how much pregnancy is pregnant. Natural childbirth in a similar situation can occur only if the pregnancy is complete - more than 37 weeks, but the child should not be too large - more than 4 000 grams. Otherwise, the risk greatly increases, and most often begins to exceed the expected benefit.
Term of hospitalization in maternity hospital
Also often there is a question about the termhospitalization of a woman in the maternity hospital, which plans natural delivery after cesarean section. It is very common practice when a pregnant woman is put in a maternity ward in advance, one to two weeks before the expected date of delivery. As a rule, the following happens next: approximately on the day of the expected date of birth, or a little earlier the doctors pierce the fetal bladder, after which they begin to artificially stimulate the onset of labor. All this procedure is carried out in the daytime, when all the doctors are at their workplaces. Doctors explain these actions by ensuring maximum safety for mom and baby. However, this practice has not only supporters, but also ardent opponents. They motivate their position by the fact that the artificial stimulation of childbirth has only one danger, but the fatal one is the rupture of the uterine scar. After all, if there is an artificial stimulation of labor, the cervix opens sharply and unevenly. In the same case, if the birth begins naturally, the opening of the cervix is very smooth, which greatly reduces the burden on the uterus itself. During natural childbirth, the risk that the scar will burst unexpectedly, is almost equal to zero - any experienced physician will be able to timely notice the threat and take all the necessary measures in this situation. Strictly speaking, all such births should be carried out under threefold control and attention to the condition of the woman giving birth. After the placenta retires, a mandatory condition is a manual examination of the scar condition, of course, under general anesthesia. 
Effect of childbirth on the child
Despite the fact that recently allMore and more obstetrician doctors - gynecologists actively propagate natural births after cesarean section, of course, provided that there is no contraindication to this, in fact the situation does not change so much. And, despite the fact that almost all women are ready to go through a longer period of recovery after a second cesarean section for the sake of getting rid of the birth pain, few of them think about how the child is affected by one or the other way of birth. But for child birth - much more stress than for his mother, because during the passage of the child through the birth canal, he undergoes severe pressure on the bones of the skull. However, during the appearance of the baby by cesarean section, stress is incommensurably greater than during the time of natural delivery. After all, the child at the time of Caesarean section falls into the environment extremely sharply, and not gradually, as it should be in the norm. Namely because of this sharp birth in the child's body, it simply does not have enough time to develop the so-called stress hormone in the necessary amount. The purpose of this hormone is to facilitate the adaptation of the child's organism to the environment. That's why almost all the babies that were born with the help of caesarean section. Indicators of all vital processes in such children reach their normal values only by the end of the seventh - the tenth week.
Think for yourself, decide for yourself ...
As you could see for yourself, naturalbirth is still much better for both mother and baby. However, as already mentioned above, there are a number of women who have absolute indications for caesarean section. For them, the most optimal option, which does not endanger the life of the mother and child, will be a second cesarean section. That is why the future mother should not give in to advice, persuasion and pressure from anyone else's side - mothers, relatives, girlfriends, by the word of all those who are very, very far from medicine. The only person to whose opinion the future mother should really listen is the obstetrician-gynecologist. Only a doctor can adequately assess your body condition, the status of the uterine scar, weigh all the pros and cons of one and the other way of the birth of your baby. And in any case, do not ignore the help of obstetricians - gynecologists. To the great regret, often, despite the high level of modern medicine, many women recklessly hope for "maybe". Doing this in no case it is impossible, because otherwise the risk of development of various complications is very great. But it depends on you depends on the well-being of your crumbs. And remember that in principle, if you do not manage to give birth in exactly the way you wanted, do not get too upset. After all, however that may be, your long-awaited crumb will not become less loved and happy from it. So rejoice your child, without upsetting without special need for that! We advise you to read:
