One of the main contributing factors for women having a repeat Caesarean (or even their first Caesarean) is because their caregiver felt they were not progressing fast enough in labour. This can also be referred to as 'labour dystocia' or 'prolonged labour'. Time limits can mean having interventions too early, unnecessarily. If you and the baby are well request more time. There is no evidence to support an increased risk of a uterine rupture if the labour is prolonged. You can read more about this in Class 4,
slow progress.
Movement and positioning
Having the ability to move freely in labour promotes good progress for dilating the cervix and pushing your baby out, often reducing your need for medical pain relief. Using walking, pelvic rocking, heat packs, bean bags, showers and baths are all ways of avoiding interventions, and decreasing your chances of having a repeat Caesarean.
Continuous fetal monitoring
Continuous fetal monitoring involves a machine continuously recording your baby's heart rate, either with an external monitor or an internal monitor (attached to the baby's head). It is aimed at detecting if the baby is distressed, or when they are not coping in the uterus. The baby may be distressed if their heart rate is abnormally high, or low, for extended periods after a contraction (usually dropping below normal for a minute or more) and can be a sign of uterine rupture.
It has been shown that fetal distress is able to be detected by monitoring babies intermittently (That is listening to the heart rate for 30 seconds to 1 minute, straight after a contraction by your caregiver at least every 1/2 an hour in the 1st stage of labour and about every 5-15 minutes in the second stage or when you are pushing). In the case of a uterine rupture, a deviation from the normal heart rate would need to be acted on within 15 to 20 minutes, thus the common recommendation to listen to the baby every 15 minutes, when planning a VBAC.