Can someone tell me if a lady has had a C-sec, a classic one, is it mandatory for her to have another C-sec for the next child?
Someone I know was telling me that her doctor has not given her any other option.
Yes it is !
There are two types of C-sections.....Lower segment and Classical , basically the difference is in where the scar is sited in the womb( uterus ).
In case of the Classical since the scar (incision ) is taken in the upper part of the uterus there are higher chances of scar giving way( uterine ruptire risk of 200--900/ 10,000) and that is why we do not allow them to go upto Term ( i.e 40 completed weeks ) as we don't want these patients to go into spontaneous labour or start contracting . They are therefore scheduled for an Elective C-section earlier around 37 weeeks of pregnancy.
Lower segment C- sections also carry this risk ( 22--74/ 10,000 ) after a single previous C- section but it is less than that for classical scars and so if a woman has had a lower segment c-section ONCE she can be given a trial of vaginal birth under close monitoring if everything else has gone smoothly and the conditions at term allow it............as she has an overall sucess of VBAC (vaginal birth after C-section) about 72---76 %.
In practice we usually advocate Elective C-section after previous 2 Lower segment C-sections or a single previous Classical C-section .