All About Vaginal Birth After Caesarean

There's a huge myth circling around the fact that if you’ve delivered a baby through caesarean section (c section) previously, you cannot give birth vaginally. However, this isn't necessarily the case and it all depends on how your pregnancy is progressing. Vaginal birth after c section, also known as VBAC, means the vaginal delivery of a baby after a caesarean section. But before considering this procedure, there's a lot for you to know and understand.

Find out more about VBAC, whether it is appropriate for you, its benefits and risks, preparation required for VBAC, and what you can expect during the procedure below.

What Is VBAC Delivery?

VBAC is short for vaginal birth after caesarean delivery. Between 60 and 80 per cent of women who have had a previous delivery via caesarean section are able to give birth vaginally.

You may be wondering whether you could try for a vaginal delivery during your second pregnancy. Vaginal delivery may or may not be recommended by your doctor for a number of reasons, and sometimes a planned vaginal delivery can turn into an emergency caesarean section due to how the labour is progressing.

Every pregnancy is unique, and your personal situation and medical history needs to be considered holistically. Whether or not you can safely choose a vaginal delivery after a caesarean section can be a complicated question, but your doctor will be able to make a recommendation as well as explain the risks and benefits of each type of delivery.

Is VBAC Delivery Meant for You?

It’s important to let your doctor know early on if you’re interested in having a VBAC. That way, your doctor can explain the pros and cons, and you can work together to decide on the best course of action for both you and your baby.

Your doctor will consider the following factors when determining whether to recommend a VBAC:

• Your uterine incision:

Your doctor considers the type of incision that was made during your previous caesarean section. Certain types of uterine incisions can increase your risk of uterine rupture. A low transverse (horizontal) incision is the least risky and is the most commonly used incision for a caesarean delivery. A VBAC is not recommended if you’ve had a high vertical incision, which has the highest risk of rupturing.

• Your previous deliveries:

You’re likely to have more success with a VBAC this time around if you’ve already had a VBAC. However, you may still be a good candidate for a VBAC even if all of your previous deliveries were by caesarean.

• Your future deliveries:

Multiple caesarean deliveries can increase your risks, and this is something to keep in mind if you plan to have more children. Discuss family planning with your doctor so that this can also be factored into the decision-making process.

• Medical conditions or problems with the pregnancy:

A vaginal delivery carries more risk if you have certain medical conditions during your pregnancy, such as preeclampsia, or if there is a problem with the placenta, such as placenta previa, or with the baby.

• Where you plan to give birth:

The hospital or medical centre where you plan to give birth is another key factor. For example, your doctor will consider whether the facility is prepared to address any medical emergencies that may happen during your VBAC.

How Is VBAC Helpful?

Here are some of the benefits of having a VBAC as opposed to a caesarean birth:

• Abdominal surgery is avoided

• There may be less blood loss

• VBAC has a lower risk of infection and carries a lower risk of blood clots

• Vaginal deliveries have a shorter postpartum recovery time

• VBAC can help lower the risk of complications associated with multiple caesarean deliveries such as injury to the bladder or bowels, the need for a hysterectomy, or placental problems.

What Preparation is Required for a VBAC?

If your previous delivery was via a caesarean section, and you’re pregnant again, you might consider bringing up the subject of a VBAC with your doctor at your first prenatal check-up. This is a great opportunity to discuss any concerns you may have.

If your doctor is not the same one as you had at your previous delivery, make sure that your new doctor has your complete medical history, which would include all the details of your previous caesarean section and any other procedures you may have had. All this information helps your doctor assess whether a VBAC is appropriate.

What Are the Perils of a VBAC?

VBAC is not a good choice for everyone or for every situation. There are certain risks involved, including:

• Infection

• Injury

• Blood loss

• Rupturing of the caesarean scar on the uterus

• Rupturing of the uterus.

Even if you plan to have a VBAC, things can happen at the last-minute during labour or delivery, so there’s always a chance that plans may change. Your gynaecologist can go over all the details and risks with you and will ensure that you and your baby have the best possible care.

What Can You Expect During a VBAC?

During VBAC, your doctor and your entire medical team will follow the same process that is called for in a vaginal delivery. They will continuously monitor you and your baby, which will also include monitoring your baby’s heart rate. The doctor will also prepare for a caesarean section in case it’s needed.

Conclusion

A VBAC can be a good option if you previously had a caesarean section. But your doctor knows your full medical history and the progress of your current pregnancy. So, it’s crucial to talk to your doctor about your preferences to understand the safest options for you and your baby.

Keep in mind, labour and delivery can be unpredictable, so keeping an open mind and being flexible is important. Although you might have planned a VBAC, it can happen that a caesarean section might be needed in the end depending on the progress of your labour.

Worry not! Irrespective of a VBAC or a caesarean delivery again, you’ll still be holding a beautiful baby in your arms.

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