Taking Drugs While Pregnant

Having a baby when you have had a Caesarean before

You have had a previous Caesarean section. This leaflet aims to give you information on your birth options in this pregnancy.

What are the chances of having a vaginal birth?

Many women who have had a Caesarean section can safely have a vaginal birth in a subsequent labour. This is known as Vaginal Birth after Caesarean section (VBAC). As long as there are no reasons not to, you will be offered and encouraged to try for a vaginal delivery. The evidence suggests that this is advantageous for you and has no significant adverse effect on your baby. Studies have shown that of those women who chose vaginal birth after Caesarean section, between 60 – 83% would be successful.

What are the risks of attempting a vaginal birth?

A mother who has had a previous Caesarean has a small risk of the womb (uterus) rupturing. This happens because the scar on the uterus tears open during the strain of labour; the risk of this happening is around 1 in 300 (0.35%). If your labour is induced the risk of scar rupture is higher at up to 2 – 3% (depending on the method used). However, you are more likely to need a Caesarean section for reasons other than scar rupture, e.g. the baby becoming distressed during labour or not making good progress.It is because of this small risk of scar rupture that you are advised to have your baby in hospital, with monitoring of your baby’s heart and facilities to perform an immediate repeat Caesarean if needed. If scar rupture occurs in the hospital setting the chances for you and your baby are excellent.The progress of your labour will be closely watched and if you are not making good progress a repeat Caesarean will be advised. You will be able to have an epidural during labour, if you wish.If you give birth vaginally you will have an even better chance of future vaginal births, avoiding the risks of a repeat Caesarean.

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The last few weeks of your pregnancy can certainly drag by, especially if you feel uncomfortable or are lacking in sleep!  You’ll be excited to meet your new baby and anxious to induce labor and delivery.  So what can you do naturally to help bring labor on? 

Natural Ways to Induce Labor – Walking:

Walking helps regulate your contractions and the natural movement of your hips helps to bring the baby into proper alignment.  By being upright you are also using gravity to bring your baby downward.  Just don’t exhaust yourself TOO early!

Natural Ways to Induce Labor – Sex:

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A birth plan is a non-confrontational way for you to make your labor and birth plans known to anyone involved with you on your special day.  You can hand a copy to your mother, your doctor or midwife, the nurses on call, your doula, and even your husband if he wasn’t involved in writing it!  Birth plans also help you to think of all possible labor and birth scenarios up front, so that you are not forced to make an important decision in the middle of a contraction or when you are unable to completely focus. 

You’ll want to take your birth plan to one of your appointments in the third trimester and get your doctor/midwife to sign off on it.  Have them make a copy of it and place it in your file so that if they do not end up delivering you, the doctor on call knows that your doctor signed off on it and is ok with it.  (It also helps in case you forgot your copy at home!)

Do keep in mind that you cannot predict everything and just because you want an ideal birth, does not mean you’ll get it!  You’ll want to remain flexible in case an emergency situation comes up or your labor is not progressing as planned.

Questions to be Addressed in Your Birth Plan:
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Why a Birth Center?

If you do not want to give birth in a hospital, but you’re too afraid to try a homebirth, giving birth in a birth center might be the solution for you. A birth center can provide you with the environment and surroundings you are looking for, but still offer medical support if needed. Birth centers can be in an independent location, or within a hospital. A certified nurse-midwife will assist you with the majority of your care at the birth center, although a physician is usually on call in case of an emergency.

Benefits of a Birth Center

A birth center offers you a comfortable, relaxed location to have your baby. They are usually more open to allowing you to try various positions and labor techniques, and will not intervene or suggest pain medication unless requested. You will typically labor, deliver, and recover in the same room. You will receive support for your labor, birth, and breastfeeding at a birth center.

Drawbacks of a Birth Center

The drawbacks of a birth center arise if there are any complications during labor or delivery or if your newborn needs any medical attention – you might need to be transfered to a medical facility or to the labor and delivery floor within your hospital (this happened to me during the birth of my first daughter!)

Make sure to contact your insurance about whether or not a birth center is covered under your plan. You may need to make other arrangements for prenatal care and then switch to a birth center for the delivery if the birth center is not covered.

There are many signs that you are about to enter labor.  Keep in mind though that you may experience NONE of these signs, or you may experience them and labor may not set in for days!

Signs of Labor – False Labor

False labor (sometimes called Braxton Hicks) consist of irregular contractions that can cause discomfort and tightening.  The interval between Broxton Hicks contractions is irregular and contractions are shorter.  In most cases, walking, drinking some fluids, or lying down on the left side can ease the pain.  If the contractions go away, you are not in active labor.

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Why a Homebirth?

Giving birth at home is a safe option for women who have had a great pregnancy, have not previously had a c-section, and have low risk for complications during birth. You should definitely consider finding a certified nurse-midwife or a qualified physician to assist you during the delivery process and help you with prenatal care.

Studies done comparing hospital and homebirths indicate fewer deaths,

injuries and infections for homebirths supervised by a trained attendant than for hospital births.

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