Features of pregnancy after cesarean section
According to doctors, between pregnancies the optimal break should be at least two years. Mom during this time has time to feed the baby to the breast and prolong lactation for at least another year. This is the most favorable effect on the health of the baby and mother. During these two years, hormonal balance returns to normal. If there was a caesarean section, then the scar has time to heal enough to withstand the new load.
According to the observations of physicians, when a woman gives birth with a break of less than two years, she more often develop complications of pregnancy (late preeclampsia, anemia, toxemia), the risk of miscarriage is higher. In this case, it is not easy for a previously born child. He may lack nutrients, vitamins, rare minerals due to the termination of breastfeeding. As a result, the child grows slightly weakened, with reduced immunity.
But to delay the break between pregnancies is not worth it. A difference of 2–5 years is considered ideal. This is the optimal break both in the opinion of the doctors and in the opinion of the children's psychologists. After all, giving birth to the same age, a woman is forced to be controlled at once with two young children, who demand unconditional attention. And when the first child is older than the second by more than five years, children grow up in different generations. They because of a decent difference in age can be difficult to really get close.
When giving birth again, a woman should prepare for a harder bearing and giving birth. Since 2-4 children are slightly larger and heavier than the previous one. But starting from the fifth, children become smaller, as the mother's body wears out. The main reason is non-compliance with the optimal break between pregnancies.
The problems of pregnant women with a very long break
Too big break between pregnancies (more than ten years) according to the observations of doctors, equates a woman to a primiparous. It is believed that the body is already forgetting how to carry a child. You can’t call it a bad factor, because instead of biological memory of the body, experience is saved, childcare skills are quickly recalled. But the problem may be the age of the woman. If the future mother is well past thirty, there may be health problems for both the parturient and the developing fetus.
It is said that the second late pregnancy is harder than the first. In fact, this is not an axiom. The course of pregnancy depends on many reasons. For example, from the sex of the child. It has been observed that the manifestations of toxicosis in mothers of girls and mothers of boys differ. If the second child is conceived from another man, he, too, can develop quite differently than the first. But more often the second pregnancy, even with a break of more than five years, is easier than the first. A woman knows what awaits her, so she suffers less stress. Emotional well-being is very important.
By the way, women feel the movement of the second child a couple of weeks earlier. Affects biological memory. The joy of touching the child, they learn already at 16-17 week. During the first pregnancy, only the most sensitive future mothers feel fetal movements before the 18th week of pregnancy.
The optimal break between pregnancies: for the health of mother and child
The optimal break between pregnancies: for the health of mother and child
After giving birth, more often - the first child, many parents ask themselves: how much time does a woman need to recover and prepare for the next pregnancy?
Larisa (name changed) considered herself the happiest woman, because after almost 10 years of waiting, she became a mom for the second time. Tears were forgotten due to several miscarriages - the little daughter was sleeping in the cradle. And what was the surprise of our heroine, when 2 months after giving birth she felt familiar symptoms. Not believing her eyes, she saw two strips on the test for pregnancy and was confused. The third pregnancy was difficult, with numerous threats of miscarriage, but after 9 months a boy was born in the family.
Larisa considers her pace to be a reward for the years of waiting and believes that she made the right decision, refusing to abort the third pregnancy that occurred almost immediately after giving birth. What is the interval between pregnancies obstetrician-gynecologists call the best, so that a woman can fully recover and her body is prepared for a new pregnancy?
According to the result of a study conducted with the participation of more than 170 thousand
children, babies conceived with an interval of less than 6 months or more than 120 months
between pregnancies, there was an increased risk of preterm birth, low
birth weight or abnormalities in the development of the fetus during pregnancy.
Arithmetic break between two pregnancies
Break for pregnancy ending in natural childbirth
According to obstetricians and gynecologists, the optimal interval between pregnancies, if the previous one ended with independent childbirth, is 2–2.5 years. The following are taken into account:
- 1 year - feeding the baby with breast milk,
- 9 months - recovery of the woman’s body after a breastfeeding period.
However, in order to minimize possible difficulties during the subsequent pregnancy, it is advisable to sustain an additional pause as early as 6 months. Thus, the ideal interval between the birth of children will be 2.5 years.
Break for a pregnancy ending with a cesarean section
If the previous pregnancy ended in cesarean delivery, then it is important for parents for 3 years not to attempt to conceive the next baby. During this time, the scar left on the uterus after the operation should be formed and “get stronger”. After all, there are cases when the place of attachment of the ovum fell on the area of the postoperative scar. With the growth of the uterus during pregnancy, the “fragile” scar may become thinner and even disperse from the load, which adversely affects the course of pregnancy and the health of the fetus.
In order to minimize potential threats to the course of another pregnancy, women who have undergone a Cesarean section are recommended to make an ultrasound of the uterus before choosing the optimal time for conception.
The recovery process of the female body after childbirth
During 9 months of pregnancy, the woman's body spends all the power to carry the baby. After giving birth, her body begins to recover and return to its former state. And this period is quite long, since they should return to normal:
- reproductive organs (uterus, ovaries, cervix, vagina and perineum, mammary glands),
- pelvic floor muscles
- the endocrine system, in particular the ovaries, which produce female sex hormones - estrogen and progesterone,
- the menstrual cycle - it should become regular,
- composition and amount of blood
- level of vitamins and trace elements,
- protein level.
Short break between pregnancies: “for” and “against”
"For" a short break:
- to give birth to children the same time means to leave sleepless nights (breastfeeding, changing diapers, potty training, problems due to colic and teething) more quickly,
- children born with a small time interval will be closer to each other in interests and hobbies,
- the opportunity not to interrupt the career again due to maternity leave and parental leave.
"Against" a short break:
- having a child under 3 years old will not allow a pregnant woman to look after her health as fully as in a previous pregnancy,
- upon the occurrence of a new pregnancy, it is necessary to interrupt breastfeeding of an already-born baby, since this may provoke an increase in the tone of the uterus and cause a threatened abortion,
- performing daily homework and caring for a child under 3 years old can cause physical and psychological discomfort against the background of a new pregnancy.
American scientists studied information about the birth of 400 thousand women and came
concluded that a 3-year break between pregnancies benefits not only
children, but also expectant mothers. During the next childbirth, they are almost
Do not experience anemia, irregular blood pressure or bleeding.
What do the doctor's say?
From a physiological point of view, a woman can become pregnant almost immediately after childbirth, and, as you know, breastfeeding is not always a hindrance. For example, the earliest ovulation after childbirth was registered on the 7th week of a woman who is breastfeeding and on the 4th week of a non-nursing woman. However, bearing a pregnancy immediately after childbirth is a big burden on an unreconstructed organism.
After natural childbirth
To avoid complications, doctors recommend to take a break between childbirth and the next pregnancy for at least 1 year, the best, from their point of view, is an interval of 2-2.5 years. Why exactly so much? It takes into account breastfeeding for a year, recovery after lactation for nine months, and about half a year is allocated for the replenishment of nutrient reserves in the body. But this does not mean that non-nursing women do not need a “respite”, because after giving birth all organs of the reproductive system, pelvic floor muscles, mammary glands, hormones, blood quantity and composition should return to normal. And, of course, they also need to replenish the internal reserves of the body.
After cesarean section
As for women who have undergone cesarean section, then, according to physicians, they need to endure an even larger interval, since it takes at least 2 years to form a wealthy scar that can withstand the durability of the next pregnancy and delivery. The best is considered a break of 3-5 years, as over time, the scar tends to thin. In any case, before conceiving you should check the viability of the scar using ultrasound.
Due to too short breaks between pregnancies, especially if there were several, the following problems may occur:
- thrombophlebitis and thrombosis of the legs and external genital organs
- preterm labor
- impaired blood flow between the fetus and the placenta
- low birth weight
- bleeding during childbirth and the postpartum period.
If a woman is too “delays” with the birth of her second child (15-20 years), then the course of pregnancy is complicated by the “baggage” of diseases accumulated along with age.
A caesarean section is a type of surgical procedure in which the fetus is removed by dissecting the anterior wall of the uterus.
The consequence of such manipulation becomes a scar on the uterine wall, the state of which is crucial in the question of the possibility of repeated delivery.
There are 2 types of incisions in the uterus, which the surgeon makes in the process of this manipulation.
- Transverse. The scar runs right at the base of the abdomen above the pubic area. On the wall of the uterus suture will be located at the bottom. From the point of view of aesthetics, the scar from such an operation is more acceptable, since after a few years it may cease to be noticeable at all. However, its main advantage is that after such an intervention, the woman will be able to give birth in the future on her own.
- Longitudinal. This is the traditional version of the operation of cesarean section, which in our time is used less and less. In this case, the scar extends slightly above the pubis line to the navel. This technique is used to save the fetus during an emergency operation. In addition, the presence of a longitudinal scar excludes the possibility of future deliveries through natural paths.
After operative delivery it is recommended to plan conception not earlier than in 2-2.5 years. This time is enough for the body to regain its strength, and they are enough for carrying another baby, as well as for the completion of the formation of the internal scar.
All this time, women need to take care of contraception in order not to get pregnant. If conception occurs after a short time, there is a risk that the scar will not be wealthy and may threaten to rupture the uterus in the process of carrying a child or in the process of giving birth.
In order to prevent this, it is necessary to consult with the gynecologist about methods of protection from unwanted pregnancy, and the features of their use. He will advise on the most appropriate method of contraception.
Artificial termination of pregnancy during this period is highly undesirable.
Even if the moral aspects of this procedure are omitted, a traumatic impact on the mucous layer of the uterus during curettage after a short period after the operation may cause the development of the inflammatory process and the appearance of various defects of the organ wall.
However, it is also not recommended to postpone the birth of the next child for too long a period (if the woman plans to become a mother again). Indeed, over time, the scar on the uterine wall undergoes atrophic changes, as a result of which the suture loses its value, becomes coarse and inelastic.
Similar processes begin to occur on average 8 years after cesarean section, therefore obstetricians and gynecologists recommend planning conception between 2 and 7 years from surgical extraction of the fetus.
Before a specialist delivers his professional verdict regarding the possibility of another pregnancy, it is necessary to conduct a number of diagnostic studies that allow a detailed assessment of the condition of the scar. The following procedures are assigned for this purpose.
- Hysterography Depending on the method of research, x-ray and ultrasound hysterography are distinguished. This technique allows you to collect the most accurate data on the state of the uterus and the degree of patency of the fallopian tubes.
- Hysteroscopy. This is an endoscopic examination of the endometrium, the mucous layer of the uterus.
These examinations are quite possible to undergo a year after cesarean, in order to give a qualitative assessment of the scar that has formed at the site of uterine tissue dissection.
At this point, the initial process of its formation will be completed. During the stage of diagnostic studies, the doctor is also tasked with finding out the type of organic tissue that makes up the scar. The most positive option, in terms of reproductive function, is muscle scar. A less well-to-do scar, consisting of connective tissue.
Features of childbirth after CS
Virtually the entire past century in the obstetric environment was dominated by the installation, according to which a woman who once became a mother through surgical delivery, all subsequent children can be born exclusively in the same way. However, modern medicine offers more opportunities.
Most obstetrician-gynecologists claim that the process of caesarean in the past is not an absolute indication for re-surgical extraction of the fetus.
Of course, if there are absolute contraindications to natural delivery, you should agree to a cesarean section and not risk your health and life of the baby for the sake of upholding its principles. However, it is not necessary, in the absence of valid reasons, to insist that your childbirth ends with a surgical extraction of the fetus.
In order for the gynecologist to approve the re-delivery, it is necessary for the expectant mother to be monitored throughout the entire period of gestation, and in time passed all the diagnostic tests assigned to her.
Important! Usually, natural births are allowed to give birth to women with a history of only one cesarean. If there is more than one scar in stock, then the gynecologist strongly recommends another surgical procedure according to current regulations.
You can give birth naturally more than 2 times, if the cause of the primary surgical extraction of the fetus became complications, which include:
- pathological prenatal position of the fetus, precluding the possibility of successful self-expulsion through the birth canal,
- late gestosis,
- developmental pathologies of the fetus requiring emergency delivery,
- acute form of inflammation in the genital tract of a woman.
If the indication for surgery was organic diseases of the eye, heart, or other disorders that were not cured until the next conception occurred, then the attending physician will most likely advise the planned surgical delivery.
Natural birth after cesarean must be carried out with special care. Therefore, quite often to such women in labor on the part of the attending physician are imposed rather stringent requirements.
- The gap between previous childbirth and this pregnancy can be at least 2, but more than 8 years.
- A scar on the uterus should be located along the horizontal axis.
- "Baby seat" should be attached as high as possible, the best option for its location - on the back wall.
- Single pregnancy. If we are talking about the pregnancy of twins, then in this case the question of the possibility of a natural resolution will not be raised.
- Предлежащей частью в малый таз должна быть головка плода.
- The scar must have satisfactory characteristics, confirmed by a number of diagnostic studies.
The final decision on how the delivery will take place is made no earlier than at 35 weeks of gestation. By this date, the main processes of the formation of the fetus and its mass gain will be completed. The doctor makes a positive verdict regarding the feasibility of the natural extraction of the fetus, if:
- child's body weight is not more than 3.7 kg,
- place of attachment of the placenta is at a sufficient distance from the scar,
- woman in labor is younger than 37 years old
- the woman has no signs of late toxicosis,
- scar in satisfactory condition and its thickness is not less than 2.5-3 mm.
Under all conditions, the attending physician may allow the woman to give birth independently. However, he must warn his patient that during labor she will not be able to inject drugs that stimulate uterine activity and anesthetics in order to avoid excessive uterine contraction, which can later cause her to rupture.
Uterine rupture is a serious complication, fortunately, in practice it occurs less frequently. Nevertheless, women are afraid of him, so no more than 18-20% of Russian women agree to an independent birth after once-cesarean.
Earlier in obstetric practice, it was decided to extract the fetus by making a longitudinal incision of the uterus, that is, in the area of greatest pressure on the organ. Nowadays, such surgical manipulations are performed by transverse dissection of the uterine wall in its lower part. This technique ensures the integrity of the body of the uterus.
The probability of damage to the structure of the uterine wall in the process of natural delivery in the presence of a transverse scar varies within 0.2%. It should also be noted that the signs of the development of this pathology can be identified in the third trimester with the help of ultrasound.
To be or not to be another pregnancy?
Although gynecologists recommend that women give themselves the opportunity to recover from childbirth, many prefer to experience the joy of motherhood again within a period of less than 2–2.5 years after giving birth. And the confirmation of this is a considerable number of children pogodok.
Expert: Irina Isaeva, obstetrician-gynecologist
Author: Elena Nersesyan-Brytkova
The perfect break between pregnancies after cesarean section
Caesarean section is often used in maternity hospitals. After the procedure, a long recovery process begins, but when it passes, many moms start thinking about having another child. However, not all of them are sure whether you can become pregnant after a cesarean section. When can you get pregnant and what complications can there be?
The perfect break after cesarean, which is recommended before pregnant a second time three years. In certain situations, the gynecologist may allow the planning of the child a little earlier than this period. Influence the decision of the doctor can the state of the mother and postoperative scar. When can one become pregnant after giving birth by cesarean, and can there be any complications during the second delivery?
Physiological aspects of body readiness for childbirth
If you evaluate the features of the female body at the physiological level, then you can get pregnant with the beginning of the menstrual cycle, that is, when breastfeeding is finished. However, the doctors concluded that before conceiving, it is better to take a break between pregnancies of two or three years.
It takes about a year and a half to rehabilitate after the first birth with caesarean. To avoid possible complications when carrying the second baby, delivery after cesarean in a year better not to plan. If you still managed to get pregnant before full recovery, then do not despair, especially to have an abortion. The fact is that when scraping during this period, the postoperative scar is severely injured. This leads to its thinning and rupture.
In medical practice, there are cases when a woman became pregnant only nine weeks after having undergone cesarean, and this gestation ended with a completely successful delivery. Therefore, do not think that after a cesarean delivery after a year will pass with complications, especially if a qualified specialist supervises the pregnancy.
The condition of the postoperative cicatrix and the doctor's verdict determine the forecast of when you can become pregnant after giving birth. The scar to the next conception must be fully tightened with muscle tissue. The condition of this suture can be assessed using the following examinations:
- Hysterography Direct and lateral x-ray of the uterus. For this study, a special contrast is introduced into the uterus.
- Hysteroscopy. Examination of the uterus is performed using an endoscope.
Experts do not recommend that mothers who have undergone caesarean plan a second conception in the following cases:
- If during cesarean a longitudinal scar was produced on the uterus. In this case, the subsequent pregnancy can be accompanied by serious problems. This is a high probability of uterine rupture, even in the early stages of gestation.
- An incision of the longitudinal type is usually formed by connective tissues, which is also a contraindication to the second conception.
Features of the second cesarean section
There is no definite answer to the question. The second cesarean section, at what time it is held? . The fact is that most women, after suffering this operation, give birth to full-term babies. The duration of pregnancy at the same time can reach the mark of 39 weeks without problems.
In the absence of indications for independent deliveries, doctors recommend consenting to re-cesarean. During this operation, a new incision is not made, the abdominal cavity is dissected along the old scar. Because of this circumstance, the woman will recover longer. After re-incision, the suture heals more painfully. This process needs to be controlled, since suppurations, the appearance of adhesive processes and other bad consequences are not excluded.
Some mothers say that the second cesarean was transferred by them much easier than the first. There was no overhang of the skin over the seam, and the scar itself became almost imperceptible. This suggests that the recovery of each mommy takes place individually. In addition, the level of medicine is now growing and, perhaps, in the near future, third birth after two Cesarean will be possible.
If a second delivery will also be performed with a cesarean, the following complications are allowed:
- Cutting tissue in the intestines, ureters or bladder,
- The development of anemia, venous thrombophlebitis of the pelvis and endometritis,
- Increased likelihood of open hypotonic bleeding that does not stop. In this case, doctors remove the uterus,
- For a baby, this operation is dangerous in the development of hypoxia and impaired blood circulation in the brain due to the woman’s prolonged stay under anesthesia. In addition, the second cesarean lasts longer than the first, which also affects the health of both the baby and the mother,
- After completing a second pregnancy with a cesarean, a full sterilization will be offered to the woman, since subsequent conceptions will carry a risk to her life.
Are natural births possible after cesarean section?
Mom can give birth to herself if:
- The baby weighs no more than three and a half pounds,
- Complied with a three-year break between pregnancies,
- The child is considered full-term and is in the main presentation,
- The postoperative scar has tightened and is in excellent condition for all indicators,
- Only one child is being hatched, that is, there is not a multiple pregnancy,
- The placenta is attached high to the location of the scar,
- The first cesarean was caused not by the physiological features of the woman, but by the situation (entanglement of the body of the umbilical cord),
- There is only one transverse incision in the uterus, not a longitudinal type,
- The woman does not have severe myopia, diabetes mellitus and she did not receive head injuries.
If during the first birth the baby was born by surgery, then you should not worry that you will not be able to get pregnant again. With proper conception planning and timely visits to the gynecologist, it is possible to give birth to a full-term and healthy baby.
Preparation for pregnancy
If a woman who has undergone a caesarean section decides to have a second child, she needs to contact an obstetrician-gynecologist. It is he who decides whether the woman’s body is now ready to take out a healthy child again and safely produce it.
If surgery was associated with genital infections or an abnormal location of the fetus in the uterus, then planning a pregnancy a second time is contraindicated.
It is advisable to plan pregnancy after cesarean section in about three years.
The longer the time after surgery, the higher the percentage to avoid such effects as placental abruption in the third trimester and its low level of location due to a fresh scar.
Pregnancy after cesarean section requires thorough preparation. Before planning a second pregnancy, protection with the use of birth control pills and barrier contraceptives is necessary. Read more about contraceptive methods →
The uterus must be restrained so that the muscle tissue is restored, and the second pregnancy after a cesarean proceeds safely, not only for the mother, but also for the child.
After a cesarean section, a woman must adhere to five basic rules:
- Well-established sleep mode in which the number of hours of rest - at least nine.
- Walking on the street that promote tissue regeneration. Forty minutes a day is the best option.
- A diet that includes vitamins and foods rich in iron, phosphorus, potassium and calcium.
- After a cesarean section, the press and the back muscles need to exercise. It can be yoga or swimming. Exercise will help muscles recover faster.
- A monthly visit to an obstetrician-gynecologist should become a habit. A specialist will help with professional advice and assess the overall condition of the body.
Women planning pregnancy after cesarean, before conceiving a second child, must be tested for hidden infections.
Moreover, the expectant mother should undergo an ultrasound scan, hysteroscopy (screening with a hysteroscope with diagnostics, and, if necessary, surgical intervention).
Hysterography diagnoses the state of a specific area of the uterus and the patency of the fallopian tubes with the introduction of a contrast agent that allows you to get an image on an x-ray.
Pregnancy immediately after cesarean is considered dangerous, because an early pregnancy after cesarean almost always ends with rupture of the scar. This is because the uterus, which has not yet recovered after the first birth, cannot withstand such a high load.
For this reason, experts do not recommend planning a pregnancy even one year after cesarean section.
During pregnancy, the state of the scar should always be monitored to ensure the possibility of independent delivery.
The failure of the scar and rupture of the uterus are the main dangers that await a woman. That is why subsequent birth at home after surgery is prohibited.
Already in the 35th week of pregnancy, a woman is placed in the clinic for preservation due to the possibility of premature discharge of amniotic fluid and further problems with the separation of the placenta.
In the case of compliance with all prescribed recommendations, childbirth passes safely, even if it is already the third pregnancy after a cesarean section. However, complications can occur.
For example, uterine rupture may occur along the scar line. This happens if the pregnancy occurred earlier than three years after the first birth.
Symptoms of uterine rupture can be nausea, vomiting, epigastric pain, unbearable pain of contractions. Uterine rupture is complete and incomplete and occurs in any of the generic periods. Sometimes it appears after childbirth. Uterine rupture is associated with an increment of the placenta and the subsequent inability of the endometrium in the area of the scar to ensure attachment.
The placenta in such situations is enlarged, possibly thickened or, conversely, thinned. If the placenta is completely adherent to the uterine wall, there is no bleeding. Spontaneous detachment of one's own bed can provoke it.
Most blood loss can be excluded only with surgical probing. If such a procedure is not carried out, the woman in labor dies from bleeding. But such a complication is rare.
Some features of suturing at the first cesarean section inevitably lead to incontinence in the first few months after childbirth, prolapse of the uterus. Read more: stitches after cesarean section →
Is natural birth after cesarean possible?
From 25 to 33 weeks of pregnancy, a specialist determines the type of birth of a woman. Every third expectant mother is able to give birth independently after surgical childbirth.
But obstetricians allow independent delivery only if the suture on the uterus is more than four millimeters thick.
Therefore, first of all, a woman is prescribed a suture examination. Childbirth takes place without stimulation in order to keep the genital organ intact.
Repeated surgery is necessary in cases where:
- too early pregnancy allowed the child to remain until the birth process, but the seam did not heal to the end,
- woman over 30 years old
- performed corporal caesarean section - when the incision is made from the very bosom to the navel,
- there is a low location of the placenta or its increment.
During natural birth after cesarean section, a specialist should constantly monitor the fetal heartbeat using cardiotocography.
If the child has a heartbeat that is a sign of problems with the scar. When the scar becomes thinner during the birth process, the uterus tone rises, the contractions become painful. The fetus suffers from oxygen deprivation, which leads to an uneven heartbeat of the child.
It is important to control the weight of the child - it should not be too large and heavy.
With multiple pregnancies, giving birth on your own is strictly forbidden.
The expectant mother should be prepared for the fact that painkillers are not injected in order to prevent uterine rupture in time in case of unforeseen circumstances. If the birth is delayed, and the child can not go out on their own, the doctor is obliged to carry out surgery.
Independent labor after two cesarean sections is a risk in which the expectant mother must understand that the uterus is thinned by two surgeries.
The probability that the genital organ will not withstand the third genera, especially natural, is more than 75%. Studies by leading gynecologists confirm that even with a high capacity for regeneration and a fully healed scar, childbirth after two cesarean sections can result in the death of the mother or birth injuries of the child.
Those women who managed to transfer natural childbirth after cesarean section, argue that with the right mood, the process is easier. If you treat natural childbirth as a long-awaited event, the pain does not seem so strong.
Women who have a low pain threshold should pay special attention to the psychological side in order to accept the fact that they will have to give birth without painkillers.
Trusted relationships with a doctor instill confidence and dull the feeling of anxiety for the child.
It is extremely important for the future mother to support loved ones. Therefore, doctors do not prohibit family members to be near the patient at all times. If a woman is surrounded by support and love, in most cases the pregnancy is successful.
Natural childbirth after cesarean section - a common phenomenon. Preparation for the second or third birth is the most important stage, determining the further development of pregnancy and the duration of the upcoming birth.
During all three trimesters, it is important to treat the child with tenderness, to protect their physical and psychological health. However, it is necessary to weigh the pros and cons before making a decision on natural childbirth and not despair if you have to resort to a cesarean section a second time.
Author: Valentina Shirokova,
specifically for Mama66.ru