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When considering delivery options in a patient with a previous Caesarean sectionthere are ultimately two care pathways for the patient:. In this article, we shall look at risks and benefits of vaginal birth after Caesarean sectionmanagement of a VBAC delivery, and special considerations. The fetus can be extruded from the uterus, resulting in fetal hypoxia and large internal maternal haemorrhage.

Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. This is the fourth edition of this guideline originally published in and revised in and under the same title.
Vaginal delivery is the method of childbirth most health experts recommend for women whose babies have reached full term. A spontaneous vaginal delivery is a vaginal delivery that happens on its own, without requiring doctors to use tools to help pull the baby out. This occurs after a pregnant woman goes through labor.
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A vaginal delivery is the birth of offspring babies in humans in mammals through the vagina. It is the natural method of birth for all mammals except monotremeswhich lay eggs into the external environment. The average length of a hospital stay for a normal vaginal delivery is 36—48 hours or with an episiotomy a surgical cut to widen the vaginal canal 48—60 hours, whereas a C-section is 72— hours.
In preparation for labor and delivery, a woman must work closely with her health care provider on such matters as whether to have a vaginal or cesarean delivery, pain management, and recognizing the signs of labor. Because there is a low risk of adverse events as a result of ECV, women who are near term with breech presentations should be offered an ECV attempt if there are no contraindications. PROM is the rupture of membranes, or water breaking, before the onset of labor.
A vaginal examination is the most intimate examination a woman is ever subjected to. It must never be performed without:. The vulva must be carefully inspected for any abnormalities, such as scars, warts, varicosities, congenital abnormalities, ulcers or discharge.
Vaginal birth after one caesarean section CS is considered safe in selected women. However, women with more than one CS in low-income settings are at higher risk of complications with vaginal birth. Thus, abdominal delivery is recommended for women with more than one CS in low-income countries unlike in high-income countries.
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