Vaginal birth after cesarean section in Greece and the contribution of the midwives

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Research

Nousia Konstantina1,2,3, Michalopoulos George2,3, Grigoriadis Charalampos4, Stournaras Stamatis1, Brezeanou Christina1, Vrachnis Nikolaos4, Farmakides George1

16th Department of Obstetrics and Gynecology, Elena Venizelou hospital, Athens, Greece
2Lito hospital, Athens, Greece
3Gaia Maternity hospital, Athens, Greece
42nd Department of Obstetrics and Gynecology, Aretaieio hospital, University of Athens Medical School, Athens, Greece

Correspondence: Farmakides George,  6th Department of Obstetrics and Gynecology, Elena Venizelou hospital, 2 Elena Venizelou Square, GR – 11521 Athens, Greece, E – mail: g.farmakides@hospital-elena.gr

Abstract

Introduction: The aim of this study was to examine the success rate and safety of vaginal delivery after cesarean section, as well as the value of midwives’ contribution in these cases. Material and Methods: This was a retrospective clinical study, including women diagnosed with singleton uncomplicated pregnancies and history of one or more previous cesarean sections, who underwent trial of labor, supported by midwives during the antepartum and intrapartum period. Results: In total, 79% of this study group achieved vaginal birth after cesarean section. No major complications, such as uterine rupture or massive obstetric hemorrhage, were observed during the trial of labor in any case. There was no need for blood transfusion, emergency cesarean section or obstetric hysterectomy in this study group. Conclusion: It seems that pregnant women who were appropriately informed and prepared from a midwife during the antepartum period achieved higher rates of vaginal birth and satisfaction from the trial. All pregnant women should be informed about the higher risk of complications after repeated cesarean sections in comparison with the potential risks of vaginal delivery after cesarean section and a trial of labor should be offered if they agree with the process in the absence of other obstetrical indications for cesarean section.

Keywords: VBAC, TOLAC, cesarean section, midwife, Greece

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