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Postpartum after CS

Hi Doc Alan,

What are the chances of VBAC after second delivery via CS?

I was told the limit of pregnancy is only up to 3 if first pregnancy is via CS.

Just getting more insights on this.

Thank you!

1 thought on “Postpartum after CS”

  1. Dr. Alan Lindemann

    Thank you Marie, the answer to this question depends on who you ask. Fifty years ago, according to ACOG, you could only have had one c-section before your VBAC and you were required to have one vaginal birth before you could be offered a VBAC. So the sequence was vaginal birth, c-section and VBAC. As I performed more VBACS over the years I found that what we offered to patients could be more flexible. I had one patient, a Nurse practitioner, who had had four c-sections and then for her fifth, a VBAC, and successful vaginal birth. So in the end, your choice depends on what you can work out with your doctor. After having done hundreds of VBACS I can say that there have been no deaths, and no injuries, not even a blood transfusion, and more than 90% have delivered successfully vaginally. After all is said and done, VBACS are safer than repeat c-sections. In the end what you do depends on what your doctor is most comfortable doing and what you agree to.

    The answer to your second question depends on what your doctor is comfortable doing and the condition of your uterus. I know of many women who have six c-sections with no trouble. Mrs. RFK senior had 12 c-sections according to my understanding. So how many c-sections are safe is a judgment call. A lot depends on how your c-section surgery is done and how you heal. There are factors that interfere with c-section scar healing like infection and endometriosis. So the advice would best be given once the previous c-section scar can be evaluated at the time of a subsequent surgery. In my opinion there really isn’t an absolute number of c-sections, but ultimately depends on you and your doctor. You might want a second opinion. AR Lindemann MD

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