Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Worried about a Second Difficult Delivery | | | QUESTION | | | Dear Dr. Greenfield,
I had Postpartum Toxemia after the birth of my only child. I ended up back in the hospital for a week because of two Grand Mal Seizures. Does this make me in the high-risk pregnancy category when I want to have a second child? And will I be able to have a vaginal delivery after the C-section I had with my first? I had a C-section because of failure to progress.— Too Scared to Have Another in Norwalk, CT | | | ANSWER |
May 25, 2001 | | | Dear Too Scared to Have Another,
You had a whole textbook worth of rotten things happen in your first pregnancy! I am glad your child did okay and that you are now in good health.
Let me start with my answer to the simpler question: Most cesareans done for failure to progress are the type that can be followed by a vaginal birth. You will need to check with your doctor to be sure it would be safe for you to try for a vaginal birth after cesarean (VBAC). The real question would be whether the next baby would fit. Often when labor doesn't progress properly it is due to subtle aspects of the baby's head position in the pelvis. Even a larger baby might fit through if he happens to be positioned slightly better. For more information, see our article Chances for Successful VBAC.
Postpartum eclampsia is a very rare event where eclampsia (seizures associated with pregnancy induced hypertension) develops after the baby is born. Pre-eclampsia and eclampsia are most common with a first baby. When the condition was severe enough to lead to seizures, the chance of having problems with blood pressure in the next pregnancy is around 35 percent, but the chance of seizures again is less than 1 percent. For more information on pregnancy-induced hypertension, see our articles on hypertension, including Treatment of Pre-Eclampsia.
Talk to your doctor about your risks for the next pregnancy. You may find that the greatest likelihood is that all will go well, and the real decision is whether you want another child to join your family.
Good luck to you.— by Marjorie Greenfield, M.D. |
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