{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T23:48:11Z","timestamp":1768693691652,"version":"3.49.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Natural childbirth could represent a deeply rooted need for\n                    many women, even in exceptional situations such as after 3 previous caesarean\n                    sections.<\/jats:p><jats:p>\n          Case presentation The first patient, a 28-year-old 6th gravida\n                    and 3rd para, first presented in the 40+3 week of pregnancy\n                    desiring a vaginal birth, after all the other hospitals in the area had refused\n                    her request. A detailed explanation of potential risks was given and, when 2\n                    days later contractions started, she gave birth to a newborn of 4450\u2009g\n                    spontaneously, without complications. A month later, a second woman, 42 years\n                    old, 5th gravida, 3rd para, read about the above-mentioned\n                    case on social media and decided to attempt a natural delivery after 3 caesarean\n                    sections at our hospital as well. She presented herself for the first time in\n                    the 41+1 week of pregnancy in our delivery room with an onset of labor\n                    after rupture of the membranes and gave birth on the same day, spontaneously\n                    without complications, to a 4150\u2009g heavy healthy newborn.<\/jats:p><jats:p>\n          Conclusions The wish to attempt a spontaneous birth after 3 previous\n                    caesarean sections can be deeply anchored and should be professionally\n                    approached by obstetricians, even if counseling and management can be\n                    challenging.<\/jats:p>","DOI":"10.1055\/a-1642-1113","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T23:49:03Z","timestamp":1641858543000},"page":"205-208","source":"Crossref","is-referenced-by-count":1,"title":["Trial of Labor and Vaginal Birth after Three Previous Cesarean\n                    Sections: Report of Two Special Cases"],"prefix":"10.1055","volume":"226","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8958-6049","authenticated-orcid":false,"given":"Arrigo","family":"Fruscalzo","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, St. Franziskus-Hospital Ahlen,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwa","family":"Elgendi","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, St. Franziskus-Hospital Ahlen,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Gantert","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, St. Franziskus-Hospital Ahlen,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,1,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1624\/105812400X87905","article-title":"Why natural childbirth?","volume":"9","author":"J A Lothian","year":"2000","journal-title":"J Perinat Educ"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.3109\/14767058.2011.640367","article-title":"Introducing routine trial of labour after caesarean section in a second level\n                    hospital setting","volume":"25","author":"A Fruscalzo","year":"2012","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1016\/S0140-6736(18)31930-5","article-title":"Short-term and long-term effects of caesarean section on the health of women and\n                    children","volume":"392","author":"J Sandall","year":"2018","journal-title":"Lancet 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delivery","volume":"108","author":"M B Landon","year":"2006","journal-title":"Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/S0301-2115(03)00082-4","article-title":"Trial of labour after two or three previous caesarean sections","volume":"110","author":"W A Spaans","year":"2003","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1080\/01443619868208","article-title":"Vaginal delivery after two or more previous caesarean sections: is trial of\n                    labour contraindicated?","volume":"18","author":"J O Emembolu","year":"1998","journal-title":"J Obstet Gynaecol"},{"key":"ref9","first-page":"255","article-title":"Vaginal birth after cesarean: a 10-year experience","volume":"84","author":"D A Miller","year":"1994","journal-title":"Obstet 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