Much has been written and studied in recent years about vaginal deliveries after cesarean section (VBAC). On the one hand, we know that it is possible to have them safely, but on the other, that this type of delivery also has certain risks.
The truth is that although the fact of having a caesarean section does not mean that you should always have a caesarean later, having a VBAC is not a decision that should be taken lightly and certain requirements must be met, so there will be cases in which It will be advisable to do so due to the possible risks that it may have for mother and baby.
Now, a new study has found that there is another factor to take into account when preparing for this type of situation, since having a vaginal delivery after a cesarean section would increase the risk of serious perineal tear by up to 20%.
The team, made up of researchers from the University of Melbourne, analyzed 130,000 births that took place between 2009 and 2014 in Victoria, Australia, in order to validate whether the risk of severe perineal tear for women who have their first VBAC is greater than for primiparous women having a vaginal delivery.
The researchers define a serious perineal tear as perineal injuries that extend to the anal sphincter, also known as third-degree perineal tears, because of the damage they cause to this muscle.
According to the study results, women who had a VBAC were significantly more likely than primiparous women to suffer a third- or fourth-degree perineal tear. In concrete figures, the risk of having a serious perineal injury increased by up to 21% .
Although the reason why this happens is not known, the team comments that one of the possible reasons why this risk increases so much is the lack of coincidence or coordination between a uterus that has already given birth to a baby, with a perineum that never has . In this case, they explain, labor progresses rapidly (as is often the case in second births), which takes time away from the perineum to stretch naturally.
The study does not seek to alarm, but to inform
The researchers also comment that the objective of the study is not to alarm, but to provide clear information on the risks, so that women can make a well-informed decision and also take the necessary preventive measures to reduce this risk.
And it is that when a tear occurs during childbirth, the wound is repaired by the doctor and usually heals completely. But in the case of third-degree tears, it can have long-term consequences , such as pelvic floor prolapse, urinary incontinence, or painful intercourse.
Can tears during childbirth be prevented?
Although there is nothing that can 100% guarantee that a perineal tear will not occur during childbirth, there are certain measures that can be taken to reduce its probability .
One of the best known is the perineal massage, whose objective is to stretch the perineum to soften it and give it elasticity , so that when the time of delivery arrives it is more prepared to open.
Other factors to consider to help reduce the risk of a perineal tear include taking care of weight gain during pregnancy, performing regular Kegel exercises to strengthen the perineal area, and trying to lead an active lifestyle during pregnancy.
Remember that each case is unique and the decision to have a second caesarean section or a VBAC is something that you should consult with your doctor , who should know all your medical history in order to analyze the different options and help you choose the one that is best for you and your baby.
Via | The Conversation
In Babies and more | Vaginal birth after C-section (VBAC) possible with minimal risk, Having a vaginal birth after C-section may be as safe as a second C-section: study
