Ask Dr. Marla: My first child was born C-section. Will my others be too?

My first child was born C-section, so does that mean all my children will have to be born like that? I really would like to have a natural childbirth to avoid the long recovery of a C-section again. 

Vaginal birth after Cesarean is called a VBAC and has a high success rate. C-sections have become more frequent and account for 15 to 25 percent of all births in North America. The benefits of having a vaginal birth include reducing blood loss, reducing injury and risk of infection, avoiding complications related to the surgery, a shorter hospital stay and a more rapid recovery. 

A C-section leaves a scar on the uterus which is a potential area of weakness. There is a possibility it could tear during labour. This is called a uterine rupture that would lead to an emergency C-section. For that reason it is important that for a safe labour after Cesarean section, you should deliver in a hospital where resources are available, should there be complications. 

The Society of Obstetricians and Gynecologists of Canada says the folllowing conditions are contraindications to vaginal birth after Caesarean section: 

• The presence of an inverted T uterine scar 
• Previous surgery that entered the uterine cavity such as the removal of a fibroid 
• A previous uterine rupture 
• The presence of a contraindication to labour such as a placenta with a malpresentation. 

The SOGC says that provided there are no contraindications, a woman with one previous transverse low segment C-section should be offered a trial of labour after a discussion of the potential risks. You do have the option of a repeat elective C-section. As always, discuss this with your health care provider.