Women who have previously undergone a c-section delivery can now safely have a vaginal birth with their future pregnancies, now known as Vaginal Birth After Caesarean (VBAC).
A few decades
ago, if a mother had ever had a pregnancy that ended with a caesarean delivery
(also called a c-section), doctors considered the woman to be only suitable for
c-sections for all her future pregnancies. For this reason, the phrase, “once a
cesarean, always a caesarian”, was used very commonly in those times.
the advancements in science and medicine, we know today that this is no longer
the case. Today, women who have previously undergone a c-section delivery can now safely
have a vaginal birth with their future pregnancies, now known as Vaginal Birth
After Caesarean (VBAC).
What is Vaginal Birth After Caesarean (VBAC)?
If a pregnant
mother has had at least one of her previous child’s birth with a c-section, she
has an option to opt for VBAC i.e. Vaginal Birth After Caesarean.Vaginal birth
after caesarean is a method of delivery which is similar to normal vaginal
birth method; the only difference is that once you go into labour with VBAC,
doctors and midwives will monitor you and the process thoroughly and more
carefully than with a normal vaginal childbirth. The doctors are also likely to
use special medical equipment to help them check on your health, as well as
that of your bub during a VBAC.
If you are in
good health, you can opt for VBAC. Around 15.5% of Australian women opt for
VBAC, since c-section is still the more popular choice for subsequent births.Here’s
what you need to know about VBAC.
Benefits of VBAC
VBAC translates to the lowest risk of complications compared to other delivery
methods. These include VBAC being:
Safer:VBAC has become the
delivery method of choice for more pregnant mothers primarily because it
reduces the risk of complications for future pregnancies. The technique used
during VBAC also decreases risks of blood clots, making it an overall safer
choice for both mother and baby. Oxytocin, a kind of hormone produced during
labour, also helps making the VBAC procedure safer for mums since it aids in
shrinking the uterus, while decreasing the chances of postpartum haemorrhage.
Healthier bub: The unique
procedure used during a VBAC is more efficient in eliminating fluids in the
lungs, which in the long term can contribute to health problems. These include
asthma, allergies, obesity, and type 1 diabetes.
Faster recovery and shorter hospital stay: A few of the biggest reasons why vaginal birth is preferred by more
women these days is because women who undergo c-section delivery have to stay
in the hospital for more number of days because they require extended bed rest
and need a comparatively longer time to recover.
undergo VBAC usually only need to be admitted into the hospital for 2 days,
while for a repeat caesarean the minimum hospital stay is seen to be around 4
days, but ofcourse this depends on different factors such as the individual’s
Only Temporary Vaginal Pain: Pregnant mums also experience only temporary vaginal pain and
discomfort after a VBAC, while a c-section would result in ongoing pain
especially around the incision. The presence of oxytocin also ripens the
cervix, and has an analgesic effect for both mother and child. Oxytocin is
known to be a natural pain-killer, which also helps assist improve the bonding
between mum and her newborn.
Lesser chances of infections post-childbirth: With a c-section, there are also chances of the new mother being re-admitted
to the hospital. This is required in the event of complications such as
possible infections and diseases, since C-Section requires healing of the
wound. With the VBAC, the chance of infections and post-childbirth diseases is
less compared towhat it is with a C-Section.
Also, just like
other forms of vaginal births, mums who opt for VBAC can safely be given pain relief medicine to help them minimize
discomfort during labour. Pain medicine, such as local anesthesia, epidurals,
and opioids are usually started once the cervix has dilated.
Disadvantages and Safety Precautions of VBAC
health concern with VBAC is the possibility of a uterine rupture. This occurs when a mother’s uterus wall ends up
opening during the process of giving birth and is straight away an emergency
situation since it involves heavy blood loss which endangers both the mother
and her baby.
The good news
here is that uterine ruptures are very rare and only occurin 1 in 200 VBAC
Should a VBAC
not go as planned, will the doctors consider an emergency-section as a backup
plan? If this happens, the mother is at risk of losing excessive amounts of blood.Sometimes, doctors wouldn’t recommend a VBAC
especially if a classic c-section was already performed in the past. Despite
this, over 70% of VBAC cases have been successful, and these mothers had no
need to undergo an emergency caesarean section.
Is VBAC Right For Me?
There are some
things you should think about carefully if you want to undergo VBAC. Remember
that every woman has a different experience when it comes to pregnancy and
labour; this is why it is difficult to predict the outcome of each delivery. A
successful VBAC depends on certain factors.
You will have a
higher success rate for VBAC if:
You have no uterine ruptures historyor other anomalies. Problems in the uterine are of serious nature. Although
the chances for this are generally low, but women with history of uterine issue
undergoing VBAC, can lead to losing her baby and also endangering her own life.
It is important to be open to your midwife or doctor if you have had a uterine
rupture in the past so that they can advise the safest delivery method.
You have the presence of an experienced healthcare
provider to monitor labour and if you and your
healthcare provider are prepared to perform a c-section if required. VBAC is a
unique procedure and not all gynecologists or doctors have experience with
this. Having one with the skill and experience is necessary to ensure a higher
success rate for your procedure.
You have no major medical problems. If you have recently suffered from medical problems or still do,
especially high blood pressure or placenta praevia during your previous
delivery, doctors will recommend undergoing a c-section instead.
Your baby is normal sized.
If your baby is larger than normal, a term referred to as fetal macrosomia,
this will greatly increase the risk of uterine rupture. A baby with fetal
macrosomia weighs over around 3 to 4 kg.
You have had atleast one successful vaginal delivery. Mothers who have already had a successful VBAC or vaginal delivery
in the past will have a higher success rate the second or third time around. It
will also help you be more familiar about what to expect, and can reduce the
You are younger than 35 years old. Regardless of your chosen delivery method, age plays an important
role in reducing or increasing the risk of complications during delivery. In
some cases, if you are beyond 35 years old, the baby may want to come out
sooner, or it may increase the risk ofa uterine rupture.
When is VBAC NOT Advisable?
VBAC may NOT be
You are overweight. It is
still possible to have a successful VBAC if you are overweight. However, the
presence of soft tissues in the pelvis can make delivery more difficult as the
baby will have a harder time coming out through the birth canal.
Your pregnancy lasts longer than 40 weeks. There are no hard and fast rules about long pregnancies and VBAC.
The reason why most doctors advice against VBAC, if your pregnancy is longer
than 40 weeks, is because it can increase the risk of uterine rupture. However
if your pregnancy is already at 42 weeks or more, the safest way to deliver
would be through induce delivery gently.
Your previous caesarian section required you to have a
T-shaped(i.e. a vertical c-section causing a
vertical scar on your belly). These incisions result in a higher risk for
rupture. VBAC is safer for women who experienced a low-transverse uterine scar,
which is a horizontal scar found above the bikini line.
You have health concerns that can affect a vaginal
delivery: Placenta problems, an infection, or
breech presentation can lower your success rate and it is likely your doctor
will recommend a c-section instead. Additionally, if you have contagious
infections such as HIV or genital herpes which can be passed on to your bub, a
VBAC is not recommended.
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