Normal Delivery After Previous Cesarean Section

QUESTION: I need more information about a normal delivery after a previous
cesarean section. My doctor has told me that it would be safe, but I thought
you had to have a cesarean once you were delivered that way. Is there
something new I should know about?
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ANSWER: It was once thought that abdominal deliveries were the only safe
route after previous cesarean deliveries, but opinions are beginning to
change. Cesarean deliveries have been constantly on the rise in the United
States, reaching more than 20% of all deliveries in 1984. Almost half of
these women were repeaters, but recent developments have demonstrated that a
vaginal delivery may not only be safe but preferable in carefully selected
patients. Some of the advantages are a shorter recovery period, less cost,
and avoiding the risks of anesthetic and postoperative complications. There
are some guidelines developed by the Committee on Maternal and Fetal Medicine
of the American College of Obstetricians and Gynecologists that are useful
when making this decision. First on their list is the recommendation that the
patient and physician discuss fully all of the pro's and con's of this option.
The classic, previously used midline abdominal incision is still considered a
contraindication to a trial of normal labor, and continuous fetal monitoring
throughout labor is considered a must. If you are only carrying one baby, and
don't expect the weight to be more that 8 lb. 11 oz., you may be an excellent
candidate.