C-Section Planning After a Complicated First Birth: A Mother's Concerns

Question
age 25
1 child
feb 23, 04

I have about five weeks left before the birth of my second child.  I'm thinking of a c section due to my first labor.  Which included Significant postpartum hemorrhage.  A long midline vaginal laceration which bled profusely and bilateral, more proximal vaginal laceration.  (Doctor's report)  Hemoglobin stabilized at 6.  I was so out of it I do not remeber the labor or birth.  Thus at this time my doctor only knows i had a bad delivery and not the extent of it.  I have to talk to him Monday and am not sure where to begin.  Is there anything I should keep in mind?  Also the pro's and con's to having a c section vs a vaginal delivery. Is it common for women to have a problem like this and be able to delivery vaginal with out any problems after?   Thank you Lindsay  

Answer
Having had a bad vaginal laceration causing hemorrhage and a low hemoglobin is NOT an indication to have a cesarean section. It is unlikely that you will again have a problem with a vaginal delivery. The first delivery is usually much more difficult that the first. Your experiences are not justification for the risks of cesarean section. It is still considered major surgery and many more complications can occur during the surgery (anesthesia complications, blood loss, bladder injury, etc). A vaginal deliveryh is still indicated in your case. The obstetrician has to be more careful in the mechanics of the delivery so as to avoid vaginal lacerations (if possible) that would cuase too much blood loss. Most women who have had the same experience as you will have a perfectly normal vaginal delivery for the second pregnancy. Discuss it with your obstetrician on Mnday.