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VBAC (Vaginal Birth after Caesarean): Understanding the benefits and risks

Are you pregnant again and did you give birth to your last baby via C-section? Your doctor may have asked you if would like to try for VBAC this time round if you are a suitable candidate and perhaps that is the reason why you have landed on this article to know the pros and cons of a VBAC.

A vaginal birthday after C-section (VBAC) is possible for most women but not safe for some especially if they have complications in their pregnancy. There are certain factors to assist you to make a decision and see if VBAC is the right choice for you.

Safety for you and your baby is the most important factor when considering VBAC.  Research shows that 60 to 80% of the women who attempted VBAC had a successful vaginal delivery.

Why would you want to consider VBAC?

If you had a C-section to deliver your child earlier, you will know that mothers take a long time to recover from it. Whereas a vaginal delivery doesn’t require any surgery which means one doesn’t have to bear the possible complications of surgery. You can be discharged from hospital sooner and you will have a quicker recovery which will allow you to resume your usual daily activities. If you would like to experience vaginal childbirth and plan to have more babies in the future, VBAC might be the right choice as VBAC helps you avoid the risks and complications of multiple caesarean deliveries such as low lying placenta.

What are the risks of attempting VBAC?

Although rare, VBAC, can cause a uterine rupture in less than 1 percent of women who attempt it. Uterine rupture is whereby the uterus tears open and an emergency C-section has to be performed immediately to prevent complications such as heavy bleeding for the mother and life threatening injury to the baby. At times, the uterus of the mother might need to be removed (hysterectomy) to stop the heavy bleeding. As you know, once the uterus is removed, a woman will not be able to conceive again. If you are considering VBAC, ensure the hospital you are delivery the baby is ready to deal with the complications which may arise from VBAC.

How will I know if I am eligible for VBAC?
To find out if you are a suitable candidate for VBAC depends on a variety of factors such as the following.

  • Did you have previous vaginal deliveries? – If you had a vaginal delivery at least once before or after your prior C-section, probability of a successful VBAC increases.
  • Type of uterine incision used for the prior C-section – Most of the doctors use a low transverse incision on the bikini line for C-section deliveries whereas some use low vertical incision. Women who had such C-sections are good VBAC candidates but if your doctor used a high vertical incision for your prior C-section, VBAC is not recommended as there is a high chance of uterine rupture.
  • How many C-sections have you had? – Some doctors will not suggest VBAC if you have had more than 2 C-sections.
  • When was your last C-section? – If you had a C-section less than 18 months ago, VBAC is not recommended for you as the risk of uterine rupture is high.
  • Is your current pregnancy high risk or do you have any complications in your pregnancy? – If you have complications with your placenta or your baby isn’t in the right position or you are carrying triplets, VBAC isn’t recommended.
  • The place you intend to deliver the baby – You need to deliver your baby at a hospital which supports VBAC and is equipped to handle an emergency C-section. Home delivery isn’t appropriate for VBAC as doctors have to constantly check on you for uterine rupture.
  • Did your doctor tell you to get induced? – If you go to labor on your own, the success rate of VBAC increases. Whereas induced labor slightly increases the chance of uterine rupture due to Pitocin and Prostaglandin which are the drugs used to induce labor.
  • Ever had a uterine rupture? – If yes, you are not a candidate for VBAC.

How does a VBAC differ from a routine vaginal birth?

If you opt for VBAC, you will go into labor similar to that of a vaginal delivery. However, your doctor will continuously monitor your baby’s heart rate and do a constant check on your scar from the previous C-section you have had to prevent a uterine rupture. Even if it occurs, your doctor will be prepared to perform an immediate C-section if required.

Here is some advice for women considering VBAC.

If you are considering VBAC, discuss the concerns with your doctor. Your doctor will need your complete medical history including the records of your previous C-sections and any other uterine procedures. Your doctor will then advise you accordingly if you should go for VBAC. Its best you find a hospital which supports VBAC and better still find a VBAC specialist to increase your chances of having a successful VBAC considering you are a suitable VBAC candidate.

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