QuestionI had a classical c-section with my physically handicappe son 8 years ago. I am now ready to try to have another child, however, I am not sure of the risks. I was told that I might have a hard time keeping a fetus alive becuase the placenta could attach to the scar since it is so big. Also, how difficult will birth be? Will I have to get the same surgery again? Or can I get a horizontal c-section? Or even a vaginal birth?
AnswerDear Jamie,
As far as carrying another baby, many women who have had previous classical C-sections have gone on to carry subsequent pregnancies to full-term. There is a slight risk that the placenta could attach to the area where there is scar tissue and this could cause problems with its correct and complete attachment to the uterine wall. However, this is not an absolute by any means and it is something you would be monitored for.
In regard to delivery, a vaginal delivery is possible, called a V-BAC (Vaginal Birth after Cesarean), but there are risks of uterine rupture at the previous incision site, especially with the classical incision. These risks would be something you would want to discuss at length with your doctor. Many doctors opt to do a repeat C-section to avoid the risks to mom and baby involved with V-BAC deliveries. They often schedule those repeat C-sections a week or two before your due date to avoid you going into labor and having that scarred uterus contract.
Rather than creating a new area of scar tissue, the previous incision would likely be re-opened. You can discuss the option of a low cervical, or "bikini", incision with your doctor as well. Sometimes those things come down to a doctor's preference and comfort zone.
I hope that this information has helped you and answers your questions. I wish you well.
Brenda
