Our Summary

This research study was conducted at the Combined Military Hospital Rawalpindi’s Obstetrics and Gynecology department. The researchers wanted to understand how often women who had previously given birth via a C-section were able to successfully give birth vaginally (a process known as VBAC). They also wanted to know the health outcomes for both the mother and the baby in successful VBAC cases. For the study, they looked at 150 women between the ages of 20-35 who were pregnant and had a previous C-section.

The results showed that almost 29% of the women who had a previous C-section were able to successfully give birth vaginally. In terms of health outcomes, they found that 2.32% had excessive bleeding, none had their C-section scars reopen, 16.28% had babies with low birth weight, 23.26% had babies with a low APGAR score (a quick test performed on a baby at 1 minute after birth), and 9.3% had babies who needed to be admitted to the neonatal intensive care unit.

The researchers concluded that by carefully selecting patients for VBAC, we could reduce the number of repeat C-sections and increase the chances of successful vaginal births.

FAQs

  1. What percentage of women who had previously given birth via C-section were able to successfully give birth vaginally in this study?
  2. What were the health outcomes for the mother and the baby in successful VBAC cases according to the study?
  3. How can the number of repeat C-sections be reduced according to the researchers?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cesarean section is that it is important to discuss the possibility of a vaginal birth after cesarean (VBAC) with your healthcare provider. Depending on your individual circumstances, VBAC may be a safe and viable option for you. It is important to weigh the risks and benefits with your doctor and make an informed decision. Additionally, following your doctor’s recommendations for post-operative care after a C-section can help promote healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended a cesarean section include:

  1. Women who have had a previous C-section and are deemed to have a high risk of uterine rupture during a vaginal birth.
  2. Women who have certain medical conditions that could make vaginal birth risky, such as placenta previa (where the placenta partially or completely covers the cervix), or certain heart conditions.
  3. Women carrying multiple babies (twins, triplets, etc.) may be recommended a cesarean section due to the increased risk of complications during vaginal birth.
  4. Women with a large baby (macrosomia) may be recommended a cesarean section to avoid complications during vaginal birth.
  5. Women who have had previous difficult or complicated vaginal births, such as prolonged labor or fetal distress, may be recommended a cesarean section to avoid similar complications.
  6. Women with certain fetal conditions, such as breech presentation (when the baby is positioned feet-first instead of head-first), may be recommended a cesarean section to reduce the risk of complications during delivery.

Overall, the decision to recommend a cesarean section is made on a case-by-case basis, taking into consideration the individual’s medical history, current health status, and the potential risks and benefits of both vaginal birth and cesarean section.

Timeline

Before the cesarean section:

  • Patient may experience labor pains and complications during labor
  • Doctor may recommend a C-section due to fetal distress, breech position, or other complications
  • Patient undergoes pre-operative preparation, including blood tests, anesthesia consultation, and consent forms

After the cesarean section:

  • Patient is taken to the recovery room for monitoring
  • Patient may experience pain at the incision site and require pain medication
  • Patient may have restrictions on movement and activities for a certain period of time
  • Patient will have follow-up appointments with the doctor to monitor healing and recovery

In the case of successful VBAC:

  • Patient may have a shorter recovery time compared to a C-section
  • Patient may experience less pain and discomfort during the recovery process
  • Patient may feel more empowered and satisfied with their birthing experience

In the case of unsuccessful VBAC:

  • Patient may require a repeat C-section if vaginal birth is not successful
  • Patient may experience disappointment and frustration with the outcome
  • Patient may have a longer recovery time compared to a successful VBAC or C-section

What to Ask Your Doctor

Some questions a patient should ask their doctor about cesarean section and VBAC include:

  1. What are the risks and benefits of having a repeat C-section versus attempting a VBAC?
  2. What factors determine if I am a good candidate for a VBAC?
  3. What is the success rate of VBAC in women with a previous C-section like mine?
  4. What steps can I take to increase my chances of having a successful VBAC?
  5. What are the potential complications for both me and my baby during a VBAC?
  6. How will my previous C-section scar affect my ability to have a VBAC?
  7. What is the hospital’s policy on VBAC and what resources are available to support me during the process?
  8. What are the options for pain management during a VBAC?
  9. How will you monitor me and my baby during a VBAC to ensure our safety?
  10. What is the plan if a VBAC is not successful and a C-section becomes necessary during labor?

Reference

Authors: Bano I, Naz S, Rashid S, Fatima Y, Humayun P, Muzaffar T. Journal: J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(4):583-587. doi: 10.55519/JAMC-04-12015. PMID: 38406940