What is the difference between a vaginal birth and a planned caesarean section when I have previously delivered by caesarean section?
There are many studies comparing a vaginal birth with a cesarean section in the groups of women who have delivered their first child by caesarean section. The studies show, among other things, that some of the women who try to give birth vaginally end up with an unplanned (emergency) caesarean section.
There are different reasons for preferring a vaginal birth or a caesarean section. Below is a list of some of the reasons which can be expressed in numbers. Think about what is important to you.
When you read the figures it is important to remember that even though there may be an increased risk the percentages are often very low – especially for the more serious complications. It may therefore be difficult to say what the percentages mean specifically for you. Ask the obstetrician if you are not sure what it means for you and your delivery.
|Abdominal adhesions due to scar tissue||35 % (24-46 %)||59 % (42-75 %)|
|Abdominal pain after 1 year||4 % (1-6 %)||More than 6 %|
|Admission to the paediatric ward within the first 24 hours due to breathing difficulty||6 %||9 %|
|Bladder inflammation||3 %||5 %|
|Rupture of the muscle of the rectum requiring stitching by a doctor (as with anyone who gives birth vaginally for the first time gang)||4 %||0 %|
|Rupture of the scar in the uterus||0,5 %||0 %|
|Perforation of a woman’s bladder||0 %||0,1 %|
Other risks associated with a caesarean section
Below, you can read about some of the risks associated with a caesarean section which we are not able to express in numbers. This applies to both planned and unplanned (emergency) caesarean sections.
Risks with fewer than 1 out of 1000 women experiencing
- Damage to the intestines or ureter, possibly requiring new surgery.
- Abdominal adhesions and scar tissue, which may increase the risk of complications if you need abdominal surgery later in life.
- Placental invasion into the scar from the caesarean section. This involves a risk of major bleeding and may require removal of the uterus. The more caesareans you have had, the greater the risk.
Risk with fewer than 1 out of 100 women experiencing
- Bleeding or inflammation after a caesarean section requiring new surgery. The more abdominal operations (caesarean section or other operations) you have had, the greater the risk.
Risk with not more than 1 out of 100 women experiencing
- Severe headache due to epidural anaesthesia in the days after the operation.
(Please be aware that this can happen regardless of whether the epidural was administered in connection with the operation or vaginal birth.)
It is important to remember that although there may be an increased risk, these are rare complications.
As a slightly more frequent complication, 1 out of 10 women experience
- Major bleeding, which may mean that you will take longer to recover from the delivery.
In general, a planned cesarean section is associated with fewer complications than an unplanned (acute) caesarean section.
Some studies have raised suspicion that delivery by caesarean section may increase the occurrence of obesity, asthma and immune-related diseases in the child later in life, but we still lack specific documentation for this.
Moreover, an equal number of women are breastfeeding after 6 months in the groups of women who have delivered vaginally and by caesarean section.