Successful natural birth after Caesarean

The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, used data on almost 144 000 British women who had their first baby by C-section between 2004 and 2011. The researchers found that 52% of them attempted a vaginal birth for their second baby.

"This study shows encouraging results with the majority of women who attempted a natural delivery after a primary C-section being successful," journal deputy editor John Thorp said in a journal news release.

Of the women who attempted a vaginal birth for their second baby, 63% had a successful delivery. Black women had a lower success rate than white women (50% vs. 66%), and women older than 34 had a lower success rate than those aged 24 and younger (59% vs. 69%).

Women aged 24 and younger were more likely to attempt natural delivery for their second child than women older than 34, the study found. And Asian women and black women were more likely than white women to attempt natural delivery for their second child.

Risk assessment

The reason for a C-section in the first birth strongly determined the likelihood of a successful vaginal delivery for the second birth. Women with a history of failed induced labour were almost twice as likely to be unsuccessful when attempting a vaginal birth after previously having a C-section.

The researchers also found that the rates of attempted and successful vaginal birth after an earlier C-section varied between hospitals for reasons that could not be explained.

Study leader Hannah Knight said an informed discussion about whether or not to attempt a vaginal delivery after a Caesarean section requires an assessment of the risk of emergency Caesarean.

"This paper provides valuable information both for women and the obstetricians and midwives caring for them," Knight, of the Royal College of Obstetricians and Gynaecologists, said in the news release.

The majority of women with an uncomplicated first C-section are candidates for a vaginal delivery the next time around, "but our data found that only half of those women chose this option," she noted.

More information

The American Academy of Paediatrics has more about Caesarean delivery.