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Are you pregnant again after you have previously given birth by cesarean section? You may have a dilemma on your hand should you have a repeat cesarean or try for a vaginal birth when the time comes? There are many pros and cons to weigh against each other for both choices, but thankfully pregnancy lasts quite a while!

A repeat c-section?

"Once a c-section, always a c-section" is the conventional wisdom in the medical community. The main risk associated with a vaginal birth following c-section is that of uterine rupture, where the uterus rips open along the line of the incision, or somewhere else. A scheduled cesarean takes this risk away, but that doesn't mean a c-section is totally safe. Cesareans still remain major abdominal surgery, with all the risks involved.

The main argument in favor of planned repeat c-sections is that emergency c-sections on women who attempted a vaginal birth after cesarean but encountered complications are much more dangerous. Those who have risk factors like a classical (vertical) incision, older mothers, or women who have never given birth vaginally before, should probably opt for a repeat c-section.

Vaginal birth after c-section

Although vaginal deliveries after c-sections can certainly be safe, not every woman is a good candidate for one. Those women who would like to give birth vaginally are best off if they had a c-section for some reason that doesn't apply this time (like twins or a breech baby), are fit and healthy, had double sutures at their c-section, and have a medical team that is experienced in dealing with VBACs. It would be wonderful if the decision to have a repeat c-section vs a vaginal birth after cesarean would be up to the mother and her family.

Unfortunately, both choices carry risks and liability also plays a very important role in which options are available for many women. If you feel strongly about either having another c-section, or trying for a vaginal birth, your best bet is to start looking for a doctor you are comfortable with early on during pregnancy.

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