How big is a scar in a caesarean section

Second caesarean section can often be avoided

Increased risk of uterine rupture after caesarean section

"Many women fear that their uterus could tear at the scar during a vaginal birth," says consultant Heinrike Pfohl from the caesarean section in Hanover. Therefore, they tend to have another caesarean section. A tear in the uterus is a dangerous complication. "A uterine rupture, however, is rare. The probability is 0.7 percent," says Hecher.

The risk increases with every caesarean section. British researchers showed that an ultrasound scan of the scar can tell the likelihood of a ruptured uterus. "The thinner the uterine wall, the greater the risk," says Kurt Hecher. "A reliable diagnosis cannot be made even with an ultrasound." Because caesarean scars can behave differently in a new pregnancy. Some scars cannot even be seen on ultrasound. Or they are relatively thick, but the tissue around them is not resilient.

Nevertheless, the experts recommend ultrasound control of the scar during the course of pregnancy. "If the tissue around the scar is very thin, less than three millimeters, a caesarean section should be recommended," says Louwen. This also applies if the caesarean section was less than a year ago or a longitudinal section was made.
"Because of the increased risk, women should choose the clinic as their place of birth," advises Louwen.

Weigh the nature of the birth carefully

Heinrike Pfohl knows that many women want a vaginal birth, but they hesitate. She recommends reading the report of the first birth to find out when and why the decision to have a cesarean section was made. A conversation with a midwife is also a good preparation. "It is important that the woman comes into contact with her body and goes into the next birth strengthened", says Pfohl. And that she is preparing for a caesarean section: "Well prepared, it can be a reconciling experience." Ideally, women should involve their partner and tell them their wishes and write them down - for example, that the baby should be placed naked on their stomach after the cesarean section.

Physician Louwen advises pregnant women to lead a healthy lifestyle with plenty of exercise and a healthy diet: "This increases the chance of a spontaneous birth." One should also ask about the re-cesarean rate in the clinic. "A low rate is a lot of effort and expense, but it is healthier for women and children."