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Why Would A Gynaecologist Choose Repeat C-section Over VBAC?

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Posted on Mon, 2 Nov 2015
Question: Why won't XXXXXXX xxxxx gynecologist who deliver 1st child C-section deliver 2nd child vaginally?
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Answered by Dr. Bonnie Berger-Durnbaugh (31 minutes later)
Brief Answer:
There are reasons for C-sec, but if these don't apply look for new OB dr.

Detailed Answer:
Hello and welcome,

There may be legitimate reasons for doing a repeat C-section rather than a VBAC (vaginal birth after Cesarian). Reasons for doing a C-section would include:

Malpresentation, such as if the baby is breech or other abnormal position
The baby's head is too large or the inside of your pelvis is too small for the baby's head to pass through (cephalopelvic disproportion)
Multiples (twins, triplets)
Fetal conditions such as very low birthweight, fetal distress during labor, etc
Severe high blood pressure during pregnancy
Mother has Herpes or HIV or other infection that poses risk for baby passing thru vagina
Pelvic obstruction by a uterine fibroid or large cyst
Attempt at medically inducing labor fails - the induction does not succeed in causing labor to progress to birth
Repeat Caesarean section - if a woman has had 2 c-sections, doctor will automatically do c-section for subsequent births.

But all of that said, if you had no complications with your previous labor, and this OB is known for having a high rate of c-sections, I would strongly advise you see a new OB. There is no reason you should stay with an OB that you do not feel comfortable with or who's decisions and practice style you question.

There are doctors who do many more c-sections than other OBs, for various reasons, that don't always have to do with the c-section being absolutely needed.

Some hospitals keep track of the rate of c-sections and degree of perineal laceration various doctors have. You can try your hospital and see if they have any data they can share.

I hope this helps.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Why Would A Gynaecologist Choose Repeat C-section Over VBAC?

Brief Answer: There are reasons for C-sec, but if these don't apply look for new OB dr. Detailed Answer: Hello and welcome, There may be legitimate reasons for doing a repeat C-section rather than a VBAC (vaginal birth after Cesarian). Reasons for doing a C-section would include: Malpresentation, such as if the baby is breech or other abnormal position The baby's head is too large or the inside of your pelvis is too small for the baby's head to pass through (cephalopelvic disproportion) Multiples (twins, triplets) Fetal conditions such as very low birthweight, fetal distress during labor, etc Severe high blood pressure during pregnancy Mother has Herpes or HIV or other infection that poses risk for baby passing thru vagina Pelvic obstruction by a uterine fibroid or large cyst Attempt at medically inducing labor fails - the induction does not succeed in causing labor to progress to birth Repeat Caesarean section - if a woman has had 2 c-sections, doctor will automatically do c-section for subsequent births. But all of that said, if you had no complications with your previous labor, and this OB is known for having a high rate of c-sections, I would strongly advise you see a new OB. There is no reason you should stay with an OB that you do not feel comfortable with or who's decisions and practice style you question. There are doctors who do many more c-sections than other OBs, for various reasons, that don't always have to do with the c-section being absolutely needed. Some hospitals keep track of the rate of c-sections and degree of perineal laceration various doctors have. You can try your hospital and see if they have any data they can share. I hope this helps.