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In recent decades the caesarean section rates have continued to rise. Up to one third (32 per cent) of births in Australia in 2011 were via caesarean section and the number is not decreasing.
That is why women need advice regarding options for birth in subsequent pregnancies.
Q: Do I need a c-section?
Years ago, doctors thought that after a woman had one c-section, she had to deliver all her other babies by c-section - that's because the uterus is cut open.
Even though the cut is stitched up and heals, obstetricians worried that the original cut could open up again when the woman went into labour.
Obstetricians now know that this rarely happens. Many women can safely have a vaginal delivery after a c-section so women can either:
- Try to go through labour and have a vaginal delivery – a trial of labour after caesarean that might work and end with a VBAC. But sometimes it doesn't work, and the woman needs another c-section
- Plan to have another c-section before labour starts
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Q: Try to have a VBAC?
“Discuss this with your obstetrician,” said obstetrician & gynaecologist Dr Dharmesh Kothari MBBS FRANZCOG of Wollongong Obstetrics & Gynaecology, who has trained in Australia and internationally since 2002 with many years of experience. “Success rate of VBAC could be between 60 to 80 per cent if you try!
“In general, a trial of labour has the highest chance of working when: a woman had a vaginal delivery in the past (in addition to having a c-section), and the first c-section was done because the baby was in a breech position.”
Q: What are the problems with a trial of labour?
“Different problems can happen but the problem obstetricians worry about most is the uterus tearing – this is an emergency. The mother and baby can be harmed if this happens. If it happens, a c-section needs to be done right away to deliver the baby and fix the tear.
“That's why your baby needs to be monitored continuously during labour. For some women, a trial of labour is not recommended – if the uterus was not cut open in the usual way during the previous c-section, or the woman had many c-sections.”
Q: Benefits of a VBAC?
“A shorter stay in the hospital after giving birth, less pain and a shorter recovery time plus fewer problems after the delivery – women who have a c-section have a higher chance of getting a fever, infection, blood clot in the legs, or needing blood.
With practices locations at at Wollongong Private and Shellharbour Private Hospitals, visit wollongongObGy.com.au for more info.