In this second article in a series on the subject of natural childbirth for mothers who previously delivered via Cesarean section, New York lawyer Robert G. Sullivan, Esq. explains that the rupture of the uterus is the most serious risk. With the option of vaginal delivery being made available to mothers who previously delivered via c-section, an understanding of this risk is essential.
For many years it was conventional medical wisdom that a patient having a Cesarean delivery could only give birth through c-section in the future. This belief was grounded in the fear of “uterine rupture,” a catastrophic event in any delivery and one believed more likely to occur in c-section patients delivering naturally. Incisions or surgical cuts are made to the uterus in Cesarean deliveries. These incisions leave bands of scar tissue, a development that may make the uterus vulnerable to tearing or rupture under the stresses of natural delivery.
In the late 1970s, it was determined that, in carefully chosen cases, a subsequent vaginal delivery could be attempted in a c-section patient if there were no unreasonable risks posed by the delivery. This remains true today.
In addition, good and accepted standards of medical care require that the mother be advised of the risks, alternatives and benefits of the choice to be made, a process known as obtaining “informed consent.”
Obtaining informed consent for a natural delivery includes not only advising of the risks of uterine rupture, but disclosing fully what the consequences of the rupture would entail. For mother and baby, the consequences of uterine rupture when it does occur, regardless of the magnitude of that risk, cannot be understated.
With a rupture, the baby is in danger of losing all oxygen. Oxygen deprivation or hypoxia can result in fetal death or permanent neurological consequences.
A uterine rupture may also result in massive blood loss, a potentially fatal complication for the mother. The injuries resulting from a ruptured uterus may be too complicated to repair with sutures. In such cases, a hysterectomy – removal of the uterus – will be performed, rendering the mother incapable of bearing children.
Of course, the emergency surgical responses taken to address uterine rupture can result in injury to the adjacent organs, including the bladder.
For all of these reasons, vaginal delivery, following previous Cesarean deliveries, should not be attempted outside of the hospital setting. Hospitals provide continuous monitoring, immediate access to blood, anesthesia, operating facilities and surgeons.
If you had one or more previous Cesarean deliveries, and sustained injuries during a later vaginal delivery, you should consult with a medical malpractice attorney. An experienced New York attorney will answer questions about potential legal actions available to you, and explain the basis for medical malpractice claims. In advance of commencing a lawsuit, qualified medical malpractice attorneys will work closely with experts in the fields of obstetrics and gynecology, and conduct a careful investigation of the care and treatment you received.
