Pregnancy
You’ve given birth by Caesarean section in the past and now you hope to give birth naturally. What are the chances?
Meet our expert, Dr Francis Elemva, gynaecologist and obstetrician, Mediclinic Sandton. ‘I developed a passion for obstetrics while I was doing my internship in a rural hospital,’ says Dr Elemva. ‘I wanted to make taking care of pregnant women and assisting during birth my everyday work and I have never looked back. I have very little time to relax. I like playing with my two sons, going to restaurants or watching home movies or soccer on TV.’
I gave birth via Caesarean three years ago? Can I now give birth naturally?
Most doctors in private practice would strongly recommend against what is termed a Vaginal Birth After Caesarean (VBAC). The worry is that your scar might rupture under the pressure of childbirth, and while research has shown this risk to be less than one percent in a first-time natural labour, it remains a major concern for most doctors as it can put your baby’s life and your life at risk.
Under what circumstances could I give birth naturally?
You would need careful consultation with your doctor and a VBAC would be dependent on a number of circumstances, including your age, whether more than two years have passed since the Caesarean and the strength of your scar. Your chances of a successful birth after a Caesarean are far higher (60%) if you’ve had at least one natural birth prior to this, and your baby comes before term.
Are there circumstances under which I could definitely not have natural birth after a Caesarean section?
Yes, there are definitely circumstances that are non-negotiable. If you or your baby were at risk, a Caesarean would be the way forward. But this would also be the case if your previous Caesarean had been a vertical cut from your belly button, which is unlikely as these are no longer common, if your baby’s head were too big for your pelvis, if your second birth is less than two years after the first, or if your scar is weak.
A weak scar could be due to your pregnancy stretching beyond term, your age being over 35, if you’ve had more than one Caesarean, or if the baby estimated weight is more than 3,5kg at term.
If your doctor has advised you to have a Caesarean, read here for more information.
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