Site contents
© 2008 BirthNet

Cesarean Birth & Vaginal Birth After Cesarean

Cesarean birth or cesarean section is major abdominal surgery -- the surgical removal of the baby through an incision in the abdominal wall and uterus.  Physical and emotional recovery from cesarean birth is longer and more difficult than from vaginal birth.  Cesarean birth also carries far more risks for mothers and babies, including risks in future pregnancies.

Cesarean birth, when done safely and when necessary, can save the lives of the mother, the baby, or both.  Unfortunately, too often cesarean birth is the result of a cascade of other interventions that either put the mother or baby in danger or disrupt the labor. 

Basic Info about Cesarean and Prevention:

Promotion of Cesarean

Increasingly, scheduled cesarean birth is being promoted as a procedure of convenience, despite the risks and the inconvenience of trying to recover from major abdominal surgery while caring for a newborn. 

Another common misconception is that cesarean birth prevents incontinence and other disorders associated with pelvic floor injuries during vaginal birth.  Research shows however, that most of those injuries are related to factors such as position during delivery, the use of medications, and particularly instrumental birth using either forceps or vacuum extraction.  Furthermore, cesarean birth can also contribute to incontinence.

Risks of Cesarean Birth versus Vaginal Birth

• CIMS “Risks of Cesarean Delivery to Mother and Baby [Link http://www.motherfriendly.org/Downloads/csec-fact-sheet.pdf]
• Childbirth Connection ’s What Every Pregnant Woman Should Know About Cesarean Section[Link http://www.childbirthconnection.org/mw/topics/cesarean/]
• “Cesarean Section” – A Guide To Effective Care In Pregnancy And Childbirth[Link http://www.childbirthconnection.org/guide/ch42.html]
• International Cesarean Awareness Network White Papers [Link http://www.ican-online.com/resources/white_papers/index.php]
• Henci Goer’s articles about Cesarean [link http://www.hencigoer.com/articles/]

Emotional Effects and Recovery

Some women experience emotional difficulties after cesarean birth, including guilt, anger, sadness, regret, depression, and symptoms of posttraumatic stress disorder.  While more common among women for whom the cesarean is unexpected, these feelings can occur even when the surgery is scheduled. 

In some cases, well-meaning family members and friends will discount these feelings in the mother in an attempt to make her feel better.  However, such feelings are not uncommon and the more support mothers receive in addressing their feelings, the sooner they will be resolved. 

The International Cesarean Awareness Network (ICAN) [Link www.ican-online.org] has chapters [link http://www.ican-online.com/community/chapters.php] throughout the US and in several other countries.  They also provide and online support group [link http://www.ican-online.com/community/emailsupport.php] and other resources for mothers experiencing distress.

Recovery Resources

• ICAN -- “Recovering from a Cesarean Birth” [Link http://www.ican-online.com/resources/white_papers/wp_recover-cs.pdf]
• ICAN – “Postpartum Depression and Post-Traumatic Stress Disorder” [link http://www.ican-online.com/resources/white_papers/wp_ppd-ptsd.pdf]
• VBAC.com – “Emotional Scars of Cesarean Birth” [link http://www.vbac.com/emotionalscars.html]
• KMom – “Emotional Recovery from a Cesarean” [link http://www.plus-size-pregnancy.org/CSANDVBAC/csemotionalrecov.htm]
• Gretchen Humphries – “You Should be Grateful” [link http://www.plus-size-pregnancy.org/CSANDVBAC/shouldbegrateful.htm]
• Breastfeeding After a Cesarean [link http://www.plus-size-pregnancy.org/CSANDVBAC/bfaftercesarean.htm]  

Birth After Cesarean

In most cases, women who have a cesarean can have a vaginal birth with the next pregnancy, referred to as Vaginal Birth after Cesarean or VBAC.  Indeed, while scheduled cesareans carry dangers for all pregnancies, multiple cesarean births put mothers at increased risk with each pregnancy.  Furthermore, for most women, VBAC is a safe option that reduces the risks associated with repeat cesarean.  The primary concern for mothers with cesarean scars is the possibility that the prior incision will rupture.  That risk is extremely small, however induction medications especially Cytotec can increase it dramatically.

Having a VBAC can be one of the most triumphant experiences of a woman’s life.  Her own belief in her ability to give birth and the support and encouragement she receives from others are probably the most important factors in VBAC success.  Even if the birth ends in a cesarean, preparation for the VBAC can help to minimize the emotional distress brought on by cesarean birth, while spontaneous labor ensures that the baby comes when he or she is ready. 

Unfortunately, the current political climate makes it difficult for women to find a provider or hospital that will allow women to try to labor, rather than schedule a repeat cesarean.  Indeed, despite a legal right to refuse any procedure or surgery, in may places in the US, including much of rural New York State, women are being forced to either agree to surgery they neither want nor need or forego giving birth in the local hospital.

VBAC Resources

• VBAC.com [link http://www.vbac.com/]
• International Cesarean Awareness Network White Papers [Link http://www.ican-online.com/resources/white_papers/index.php]
• Henci Goer’s articles about VBAC [link http://www.hencigoer.com/articles/]
•  “Should I choose VBAC or Repeat C-Section?” – Childbirth Connection [link http://www.childbirthconnection.org/mw/topics/vbac-cesarean/]
• “Labor and Birth After Previous Cesarean Section” – A Guide To Effective Care In Pregnancy And Childbirth[link http://www.childbirthconnection.org/guide/ch38.html]