As a leading ob-gyn in New York City, Dr. Pilshchik helps women prepare for vaginal delivery so they can have healthy birth experiences with far less risk of anxiety, pain or complications.
Many women who've had C-sections previously are able to have vaginal deliveries with subsequent births. In general, factors that can affect your ability to have a vaginal delivery include:
Dr. Tran-Kim will perform an in-depth evaluation to determine if vaginal birth after cesarean (VBAC) is right for you.
An episiotomy is a small cut made in the space between your vagina and anus (the perineum) that helps widen the opening for the baby's emergence. Although once they were performed as a standard part of vaginal childbirth, many women can successfully deliver without an episiotomy, relying instead on the body's production of hormones to help relax and loosen the vaginal opening. Dr. Pilshchik can discuss whether or not you may need an episiotomy during your office visits.
The vagina is designed to be highly resilient, but it can experience some stretching that can persist after delivery. Dr. Pilshchik can discuss options for helping reduce or reverse stretching, including the use of Kegel exercises during and after pregnancy.
Depending on how long you've been in delivery, your health and the health of your baby, Dr. Pilshchik may decide to use techniques such as vacuum-assisted delivery or forceps to help move the baby through the birth canal. In other cases, she may recommend a C-section to deliver the baby through an incision in the abdominal wall rather than through the vagina.
Planned cesarean sections are performed when the baby is not in an optimal position for delivery, if you have an infection that could be passed to the baby during delivery, if you're carrying multiples, or if you've had a previous C-section and a vaginal delivery is not recommended. Emergency C-sections may be performed if the baby changes position just before delivery, when there's a problem with the umbilical cord or placenta, if the baby is in distress, or if labor stops progressing or is unusually difficult. C-sections are also used when a baby is too large to be safely delivered vaginally.
In most cases, you can go home within three to five days of your C-section, although recovery and healing will take about four weeks or more to complete. During the recovery period, you'll need to avoid heavy lifting and intense exercsie, and you may need pain medicine for the first week or two. You'll also have vaginal bleeding for several weeks which should be managed with pads and not tampons.
Yes, you'll need some help with daily tasks like housework, laundry meal preparation and shopping. Depending on how you feel and how much pain medication you're taking, you may also need help driving and caring for your baby. Before leaving the hospital, you can discuss your care needs with Dr. Pilshchik and your nurse.
Yes, you will be able to nurse following your C-section.
An epidural injection will be used to numb you from the waist down, and once the area is numb, an incision will be made through the belly and uterine wall so the baby can be lifted out. The doctor will remove the placenta and then close the incision.