Normal Delivery After a Cesarean Is Common : Medicine: In survey, 58% of women who had procedure later opted for vaginal childbirth when given choice. Age of doctor a factor in decision.

About six out of 10 women who have undergone a Cesarean section during childbirth are able to give birth again without resorting to another one, according to a study released Tuesday by the American College of Obstetricians and Gynecologists.

The survey showed also that 58% of women who were given the option in their second and third deliveries chose the more traditional procedure over a Cesarean section.

And it showed that the trend toward normal vaginal deliveries was more pronounced among women whose physicians were under 35 than among those whose doctors were older.

The survey, conducted in March among 2,213 obstetricians and gynecologists, marked the first time that researchers have gathered nationwide data on preferences by women and their physicians in such cases and on how well the traditional procedure worked, the college said.

Dr. Mary Jo O’Sullivan, the organization’s secretary, said that previous studies on the issue have all been conducted in hospitals.

The data published on Tuesday showed that, although most of the women who were allowed to pick the procedure they preferred after having undergone a Cesarean section chose a normal childbirth, their physicians were a major influence in their decisions.

According to the report, more women chose vaginal births when they had been encouraged by younger physicians who had received their training more recently.

The document showed that, among women whose physicians were under 35, about 64% chose vaginal childbirth after a previous Cesarean section, but in the group whose physicians were 55 or older, about 54% chose the vaginal procedure.

Similarly, the report showed that women whose physicians had been practicing for more than 30 years were less likely to undergo traditional births than women whose physicians had been practicing 10 years or less.

The college said that women were also “more likely” to accept the option of vaginal delivery from female physicians than from male physicians--a difference the college attributed to “the younger age of most female ob/gyns.”

The survey showed that success rates appeared to vary with the age of the physicians, with newer physicians reporting higher success rates with traditional procedures than physicians who had been in practice for many years.

A Cesarean section is a surgical procedure that involves cutting through the mother’s abdominal and uterine walls to remove the baby. It is typically performed when a physician believes that a vaginal birth would place the mother or her child in danger.

Among the medical reasons for Cesareans are a difficult or excessively long labor, a breech birth, which occurs when the baby is not positioned head first, premature rupture of membranes and fetal distress.

According to the American College of Obstetricians and Gynecologists, about one-third of the Cesareans performed in this country involve women who have undergone the procedure in a previous childbirth.

For years, it was widely believed that a vaginal delivery, with its potential for prolonged labor, posed a risk for women who had undergone prior Cesareans because the scar could rupture during labor. As a result, women were routinely advised to have Cesareans again.

More than 50 years ago, however, the high, vertical incision traditionally used during a Cesarean was replaced by a small, low horizontal incision that made subsequent vaginal deliveries safer.

In an interview, O’Sullivan said attitudes “just didn’t change in this country with the new incision,” adding: “It takes a long time to change people.”

In 1980, a federal advisory panel convened by the National Institutes of Health declared that too many Cesareans were being performed in the United States and that physicians often were not giving women in labor enough time to deliver in a traditional way.

The college first issued medical guidelines for its members in 1982, outlining criteria for vaginal births following Cesareans. In 1988, however, “we really began pushing them,” O’Sullivan said.

O’Sullivan called the new trend “encouraging” but said the fact that 40% of patients are not choosing the traditional option “suggests that we need to do a better job educating women about this possibility.”