Trial of Labor and Vaginal Birth after Three Previous Cesarean Sections: Report of Two Special Cases.

Background: Natural childbirth could represent a deeply rooted need for many women, even in exceptional situations such as after 3 previous caesarean sections.

Case Presentation: The first patient, a 28-year-old 6 gravida and 3 para, first presented in the 40+3 week of pregnancy desiring a vaginal birth, after all the other hospitals in the area had refused her request. A detailed explanation of potential risks was given and, when 2 days later contractions started, she gave birth to a newborn of 4450 g spontaneously, without complications. A month later, a second woman, 42 years old, 5 gravida, 3 para, read about the above-mentioned case on social media and decided to attempt a natural delivery after 3 caesarean sections at our hospital as well. She presented herself for the first time in the 41+1 week of pregnancy in our delivery room with an onset of labor after rupture of the membranes and gave birth on the same day, spontaneously without complications, to a 4150 g heavy healthy newborn.

Conclusions: The wish to attempt a spontaneous birth after 3 previous caesarean sections can be deeply anchored and should be professionally approached by obstetricians, even if counseling and management can be challenging.