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Vaginal birth after c-section safe after due date

Women who have undergone a prior caesarean delivery can safely attempt to give birth vaginally in a subsequent pregnancy, even when they're beyond 40 weeks.

Vaginal birth after c-section safe after due date

Women who have undergone a prior caesarean delivery can safely attempt to give birth vaginally in a subsequent pregnancy, even when they're at or beyond 40 weeks. However, the chances of being able to complete a vaginal birth are reduced. The safety of vaginal birth after caesarean in a variety of situations has been investigated before but little has been published about vaginal birth after caesarean attempts for women at or past their expected delivery date. Researchers from the Hospital of the University of Pennsylvania, USA, and colleagues looked at outcomes for 11,587 women attempting vaginal birth after caesarean, before and after 40 weeks of gestation. Women at or after their estimated date of delivery were less likely to be successful (69 percent) than were women before their estimated date of delivery (78 percent). Doctors should counsel women that the chances of success of vaginal birth after caesarean are decreased in gestations that continue beyond the estimated delivery date compared with those before 40 weeks. However, patients can be reassured that the success rate of almost 70 percent is still quite good. Rates of operative complications and adverse effects for the mother were also higher for women who attempted vaginal birth after caesarean at or beyond 40 weeks of gestation but the difference disappeared once other risk factors were accounted for. Still, the researchers note, women attempting vaginal birth after caesarean fared somewhat worse overall than those opting for repeat cesarean delivery. However, the absolute risk was small. Thus, the risks of a 'vaginal birth after caesarean' attempt are not increased simply because the due date has passed.
Obstetrics & Gynecology,
October 2005
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