Q&A: I'm pregnant again after a breech delivery and I don't know if a C-section or a natural birth is better.

by Dr. Gerard M. DiLeo

I had a C-section with my first baby because he was breech! I'm pregnant again and don't know whether to have another C-section or to try for a natural birth. What are my options?

VBAC (vaginal birth after cesarean) is a personal choice between you and your doctor. Since you had a C-section because your baby was breech, not because your pelvis was too small, you have no less likelihood of a successful vaginal delivery than someone having a first baby.

There are some small risks to VBAC, such as rupture of the uterine scar, making an electively scheduled C-section your best protection from such a labor complication.

On the other hand, a C-section has more risks when compared with an uneventful vaginal delivery, like increased likelihood of infection, transfusion, etc.

There is no perfect answer, though. VBAC is officially recommended for such a case as yours, but that's the academic recommendation that doesn't take into account your doctor's opinion. Since your doctor was there at the time of your C-section and knows how the surgery went, he or she is better equipped to weigh the risk of uterine rupture vs. the complications of C-section. I'd go with your doctor's recommendation on this one.

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