Dr. Grayson shares if a woman can have a vaginal delivery following a previous cesarean section.
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Does A Woman Have To Have A Cesarean Section Following Her First Cesarean Section? Doctor Robert Grayson: There’s an increasing trend in the country for people who have had one cesarean section to have another. The reason behind that isn’t that we have a better understanding of the consequences that happen as you try to have a labor after cesarean section. We have kind of known those numbers for a long period of time. The change probably comes from the fact that we are better aware of when people have a consequence during a labor after cesarean section, what things improve the outcome of those catastrophes that occur. Those things include in-house obstetricians, people that are in the hospital, whether it’s your doctor or a group of doctors that a hospital employs to be there to intervene in the case of emergencies. It requires an anesthesiologist to be in-house, so if someone who is around that can give general anesthetic in the case of an emergency. It requires a nursery team so that if you have a catastrophe and you have a compromised baby, you have the most qualified people to provide care to that baby after the delivery. A lot of hospitals in the country don’t have those pieces. So, that leads their doctors that practice at those hospitals to recommend in their neighborhood to have a repeat cesarean section because it’s safer for the mom. At large tertiary hospitals like Banner Desert, we have all those things in place and we actually start to become a little bit of a referral hospital for patients who want a trial of labor after cesarean. Now, I don’t want to undermine the risks of trying to have a baby vaginally after C-section. I mean they are substantial though it’s rare and they can include things like severe fetal distress and fetal compromise and even fetal death. They include maternal complications including ruptures of uteruses, losses of uteruses, hysterectomies, transfusions and even maternal death, though it’s a rare event if you can quickly diagnose the process and intervene.
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