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14 March 2012, 06:03
Women who have a normal birth after they've had a previous Caesarean are 7 times more at risk of suffering a rare complication than if they have another C-section, research suggests.
An Oxford University study has also found womb rupture, where the womb wall tears open during birth, is rarer than previously thought.
However, among women having a planned vaginal birth, the risk of womb rupture was 21 per 10,000 pregnancies, seven times higher than in those who elected for another Caesarean section, where the incidence was three per 10,000 births.
Professor Marian Knight, of the National Perinatal Epidemiology Unit at Oxford University, who led the study, said:
"Among women who've had a previous Caesarean, there is a higher risk for those planning a normal birth rather than another Caesarean. But the risk remains very small, occurring in just 0.2% of such pregnancies.
"Given that this figure is lower than many previous estimates, there should be no extra reason to worry.
"We see no reason to change current advice that women can choose how they would like to have their baby after a previous Caesarean, and that in general a vaginal birth should be possible.''
There were 159 cases of womb rupture in the 13 months between 1 April 2009 and 30 April 2010. Two women died and there were 18 deaths among babies associated with the rupture.
The Royal College of Obstetricians and Gynaecologists (RCOG) says women choosing a vaginal birth have a one in 100 higher chance of needing a blood transfusion or having an infection in the womb compared with women who choose a planned Caesarean delivery.
But disadvantages of a planned repeat Caesarean include a longer and possibly more difficult operation, a higher chance of blood clots, breathing problems for the baby and a longer recovery period.
Dr Virginia Beckett, spokeswoman for the RCOG, said:
"Women who have already had a Caesarean section need to consider how they would like to deliver in their subsequent pregnancy.
"It is important that women discuss all the options for their individual case with their midwife or obstetrician."