It may be safer to go in for a planned caesarean section delivery rather than normal vaginal labour if one has already had a caesarean earlier, a recent study suggests.
From a study of the report obtained from the Scottish Morbidity Record and Stillbirth and Neonatal Death Enquiry, the odds of having a stillborn child or neonatal death and even maternal death were seen to be higher if a woman attempted to have a vaginal delivery after having had a caesarean section earlier, since there are more chances of rupture of the uterus in such a case. Planning another caesarean section was significantly less risky.
The risk of perinatal death was almost 11 times higher in women who tried a vaginal delivery after having had a caesarean earlier as against those who had a planned caesarean delivery the next time around. Women attempting a vaginal delivery after a caesarean were also 8 times more at risk of death due to mechanical causes including rupture of the uterus than other women who had no history of a prior caesarean birth. This relation was not seen in women undergoing a planned caesarean section.
The study mentions that the absolute risk of death during labour after a prior caesarean is low. It is however, higher in comparison with a repeated caesarean delivery. A caesarean section is usually only opted in cases where normal vaginal delivery is not possible due to increased risk for the mother or the baby. A caesarean section delivery does not come without its disadvantages in that the recovery time for the mother is greater apart from other complications. However, in case one has already had a caesarean delivery it may be more beneficial to opt for another one rather than to go in for a vaginal birth albeit always under the guidance of the treating obstetrician.
JAMA Vol. 287, No. 20