Vaginal Birth After Caesarean Section

Normal vaginal birth after Caesarean section is a method used daily in delivery rooms in Northern European and North America. Studies have shown that the probability of spontaneous deliveries after cesarean section is more than 60%. In the remaining 40% of cases where they did not progress or the fetus showed signs of distress, the results were repeat cesarean section. A vaginal birth after cesarean section should be managed in a delivery room in the hospital. This allows close monitoring to be conducted, as there is a small but measurable risk of serious complication (about one in 300 cases) which can endanger the health of the fetus and the mother.

Both Michael Lazanakis and the Fiona McIntosh have had, in their everyday practice in U.K, a large number of births after cesarean section and here in Greece they continue to follow strict safety protocols derived from these hospitals that they had trained and worked. These protocols include, the avoidance of drugs for induction or augmentation of labour, the fetus and the mother are closely monitored by cardiotocography and for early warning signs, the progress of labour is recorded accurately and the whole process is completed within specific time frames. Provided that all clinical factors are favourable, spontaneous onset of labour can be expected and waiting beyond the expected date of delivery maybe considered also. The mother during labour and birth, is encouraged to be as mobile as possible, to try different positions and avoid staying in bed for very long. Being active does not compromise the close monitoring of labor as previously mentioned. The use of epidural is not contraindicated but is the choice of the woman and it is not imposed.

The choice of birth after cesarean section should be based on genuine trust of the pregnant woman and the obstetrical team which is usually built at the 9 months of the antenatal care and they should set together common goals without overpassing the boundaries of a secure framework.