Vaginal Birth after Caesarean Section -
Statements of Guidelines:
Is vaginal birth possible after cesarean section?

Many women wish to have a normal, natural birth after a caesarean section, not infrequently outside the hospital setting. Two guidelines are authoritative on these questions:

1. S3 guideline 'Vaginal birth at term'.
2. criteria on births in the domestic environment

What does the S3 guideline say?
The woman should be informed about "possibilities of a vaginal birth after a caesarean section ... and other aspects". (3.2)

GreenBirth:
These topics, important for parents, are only briefly covered in the LL, (guidelines), why? Because criteria for out-of-hospital births are involved here as well. That is why we refer to these "Criteria for births in the domestic environment" - which also concern births in a birth center.

These criteria are binding for the billing of midwives with health insurance companies (as of 2022).
What does the criteria say about births in the home environment, in relation to births after cesarean section?
(Sectio caesarea, = 1 x cesarean section - Re-sectio = 2 x cesarean section).

- If the first child was born by cesarean section, birth at home or in a birth center is possible thereafter.

- In the case of a re-section without subsequent vaginal birth, an out-of-hospital birth is not billable to the health insurance (p.3).

Condition after re-section means that the woman has already had 2 cesarean sections. If the woman subsequently wants to give birth at home, the midwife cannot bill this to the health insurance company.

- Due to her right of self-determination, the woman is "allowed" to strive for a home birth even after two caesarean sections , but all professional societies position themselves against this because of the increased risk of uterine rupture.

The midwife may decide on a case-by-case basis what she can and wants to support as a self-pay service (the parents reimburse the midwife).The file name contains an invalid extension

Translated with www.DeepL.com/Translator (free version) -
Eva-Maria Müller-Markfort, midwifw

03/2023