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My wife is now 4 months into our second pregnancy. Our first child was born via caesarean section. Our doctor told us that since the second child will be born within 2 years of the c-section, the second child will be born via c-section as well. Actually, this is sad news for us, because we really want our children born vaginally.

I would like to make sure that what the doctor said is right. Is there any valid research which shows that the minimal range to give birth vaginally is 2 years after having caesarean section? What are the chances that my wife will be able to give birth vaginally?

Hopefully, one of you guys have had the same experiences as my wife and will please share here.

Thank you.

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2 Answers

up vote 4 down vote accepted

It is the current practice at many medical facilities to automatically schedule a c-section for any child after a previous medically-necessary c-section. This is somewhat controversial, as the risks of VBAC (Vaginal Birth After C-Section) may be less than originally thought. Some studies show that between 74% and 82% of women attempting a trial of labor after a c-section had successful vaginal deliveries.

However, I can find no indication that 2 years separation is a hard factor in this. I can only find some examples of anecdotal evidence that claims that 18 months between deliveries is the minimum. The site childbirthconnection.org also mentions an 18 month delay between deliveries as being the minimum to reduce the chance of having scar-related problems.

Other factors seem to be:

The chances of a successful VBAC are higher if:

  • You've had only one prior low transverse uterine incision — the most common type for a C-section — and no other uterine incisions
  • You and your baby are healthy and your pregnancy is progressing normally
  • The reason you had your prior C-section isn't a factor this time
  • Your labor begins naturally on or before your due date
  • You've had a previous successful vaginal delivery

The chances of a successful VBAC are lower if:

  • Your pregnancy continues beyond your due date
  • You have an unusually large baby
  • You've had two or more C-sections and no vaginal deliveries

I know a couple who recently had their second child, after an initial c-section. The mother was very set on attempting a VBAC, and had to change hospitals to find one willing to even allow them to attempt it. The second child was born 3 years after the first, rather than two, but she did have the birth vaginally without incident.

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18 months delay between deliveries? so this mean that 18 months from first birth to second birth right? :) –  kalingga Jan 1 '13 at 2:09
    
@kalingga That's how I read it, yes. Although that seems to assume the first C-section was a low transverse uterine incision. Some other types of incisions are much more prone to tearing on subsequent c-sections. –  Beofett Jan 1 '13 at 4:26
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I've heard that some OBs require 2 years (and most midwives do), but many do not put any limit on it. The important thing is to find a doctor who is a proponent of a VBAC and have a long conversation about it. –  justkt Jan 2 '13 at 13:41
    
@Beofett yes, the first C-section was a low transverse uterine incision, anyway thanks for your complete answer. Before reading your answer, i haven't know yet about VBAC. –  kalingga Jan 2 '13 at 16:22
    
@juskt thanks for supportive comment ^^ –  kalingga Jan 2 '13 at 16:23
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What you are talking about is called vaginal birth after cesarean (VBAC). You should do some research and decide if it's really the right thing for you. I don't see anything in there about two years, but that may be the obstetrician's experience. If you research and still think it's for you, your next step is probably to find an obstetrician and a hospital that will support your decision.

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hmm yes, finding doctor/ hospital which support VBAC seem difficult. –  kalingga Jan 1 '13 at 9:14
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If you can't find an OB who will support your decision to attempt a VBAC (assuming you have low risk-factors), you might try finding a Certified Nurse Midwife instead. Once you find a practitioner, they should be able to direct you to a facility that would support you as well. –  Meg Coates Jan 2 '13 at 4:10
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