Vaginal birth after Cesarean (VBAC)

>> Monday, January 30, 2012

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Vaginal delivery of a second baby following C-section of the first baby is possible (VBAC), but some women are better candidates for this than others. It is essential to completely inform the patient and her husband or father of the baby about all the risks involved as labor progresses and the uterus continues to contract. The more the cervix dilates the thinner the lower segment becomes. This is normal and helps the infant to fit easier through the birth canal. However as it becomes thinner and the baby’s head comes down lower, it puts more and more stress on the tissue and can cause the old incision site to open up . If this happens it is considered an emergency and we have about ten minutes or less to deliver the baby safely,

I am the on-call doctor so the patient is informed and now I am required to remain at the hospital the entire time she is in labor; this is for the safety of mom and baby. If the uterine scar would open up during labor (uterine rupture), the contractions would push the baby outside the uterus into her abdomen and the uterus would shrink down which would cause the placenta to separate prematurely. Now the baby is free-floating in the abdomen with all the oxygen and nutrients cut off. Next the uterus begins to hemorrhage and this puts the mother’s life in danger and there is only a few minutes to intervene.

Fortunately, most of the time everything goes well and we are able to keep a close eye on the labor and delivery of these patients. Thank goodness most babies are born healthy.

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