Women opting for a C-section after a previous Caesarean delivery are less likely to suffer severe complications, two studies suggest.
Australian researchers found the risk of stillbirth was lower in women who had a planned repeat C-section rather than trying for a natural labour. Meanwhile, a UK study found the chance of womb rupture was reduced when mothers had an elective repeat section.
Women who have had a C-section face a dilemma in their next pregnancy about whether to try for a vaginal birth, or to have a repeat section. The current UK guidelines state that women should be able to choose after discussing the issue with their doctor.
The UK research is the first to compile national data about the risk of womb rupture – a serious complication of pregnancy, which can cause severe blood loss in the mother and put the baby at risk.
In women who had a previous C-section, the risk of the womb rupturing during labour was seven times higher if they tried for a natural labour, compared with a planned C-section. The risk of the baby dying was three times higher.
A second study followed more than 2,000 pregnant women planning their second delivery after a previous Caesarean section at 14 hospitals in Australia.
Researchers concluded that “Among women with one prior Caesarean, planned elective repeat Caesarean compared with planned vaginal birth after Caesarean was associated with a lower risk of foetal and infant death or serious infant outcome.”
Commenting on the studies, Dr Virginia Beckett, spokesperson for the UK’s Royal College of Obstetricians and Gynaecologists (RCOG), said: “Choosing a vaginal birth or a Caesarean section carries different risks and benefits but overall either choice is safe with only very small risks.
“It is important that women discuss all the options for their individual case with their midwife or obstetrician. Despite there being a slightly higher risk of rupture following a previous Caesarean, the procedure itself carries risks such as risk of blood clots, longer recovery period and the potential need for elective Caesarean in future pregnancies.”
Sue Macdonald, the Royal College of Midwives’ education and research manager, said: “The information from the study will add to the evidence base and knowledge for midwives and obstetricians and allow them to be able to discuss with women their options for birth after a Caesarean section and whether a normal birth would be possible.”