In this article:
You don’t need to rush into a decision. Take your time, ask questions, and think about what feels right. Understanding its benefits and risks is important for a well-informed decision.
What is Vaginal Birth After Caesarean Section (VBAC)?
VBAC refers to a vaginal delivery after a previous caesarean section. This challenges the outdated belief that all births following a caesarean section must be surgical.Known as a Trial of Labour After Caesarean (TOLAC), VBAC aims to achieve a vaginal birth but may result in an emergency caesarean section if complications arise. This option appeals to individuals who wish to experience natural childbirth, provided it’s deemed safe by their healthcare professional.
Benefits of Vaginal Birth After Caesarean Section
VBAC offers many advantages for you and your baby, impacting physical recovery, emotional well-being, and future pregnancies. Some of the benefits are:- Shorter recovery time: Vaginal delivery typically means a quicker return to daily activities and a shorter hospital stay compared to a caesarean section.
- No surgery: VBAC avoids the need for surgical incisions and reduces the risk of complications associated with abdominal surgery.
- Lower risk of infection and bleeding: Vaginal delivery carries a lower chance of serious blood loss or infection than a caesarean section.
- Emotional satisfaction: Allows for an empowering birth experience with active participation in the process.
- Baby’s health: Vaginal birth clears amniotic fluid from the baby’s lungs, reducing respiratory issues. It also exposes the baby to beneficial bacteria, which boosts immunity.
- Future pregnancy benefits: Reduces risks of placental complications, for example, placenta accreta or previa, associated with multiple caesarean sections.
Risks of Vaginal Birth After Caesarean Section
VBAC has many benefits, but it also carries potential risks that require careful consideration. Discussing these with your healthcare professional is important.- Uterine rupture: A rare but serious complication where the caesarean section scar on the uterus tears. This may potentially require an emergency caesarean section or hysterectomy.
- Emergency caesarean section risks: An unsuccessful VBAC may lead to a riskier emergency caesarean section compared to a planned one.
- Infection and blood loss: Possible during labour or if an emergency caesarean section is needed.
Eligibility for Vaginal Birth After Caesarean Section
Not every woman is a candidate for VBAC. Eligibility depends on various factors related to your health, pregnancy, and previous deliveries.Take a look at the eligibility criteria below to help you understand if this is a safe option for you:
- Low transverse incision: Women with a horizontal cut on the lower uterus have the lowest risk of rupture and are often eligible.
- No uterine rupture history: A prior rupture disqualifies you due to increased risk.
- No major uterine surgeries: Surgeries like fibroid removal increase rupture risk, making VBAC less advisable.
- Previous vaginal delivery: Having delivered vaginally before or after a caesarean section.
- Pregnancy spacing: At least 18 months since the last delivery reduces rupture risk.
- Single or two prior caesarean sections: VBAC is often feasible in such cases, but risks increase with more caesarean sections.
- Health and pregnancy factors: VBAC may not be advised if you have conditions like placenta problems, a foetus in a difficult position, preeclampsia, or if labour needs to be induced.
Factors Affecting Vaginal Birth After Caesarean Section Success
Your chances of a successful VBAC depend on specific situations. Knowing these factors helps set realistic expectations.Higher Success Factors
- Prior vaginal birth or successful VBAC.
- Spontaneous labour before the due date.
- Younger maternal age (under 35).
- Healthy weight and no medical conditions like preeclampsia.
Lower Success Factors
- Previous caesarean section due to labour dystocia (failure to progress).
- Obesity or a large foetus.
- Short interval between pregnancies.
- Post-term pregnancy or multiple foetuses.
Preparing for a Vaginal Birth After Caesarean Section
Preparation is crucial to a safe and successful VBAC. Below are some key steps to help you prepare:- Choose an experienced doctor: Work with a doctor skilled in VBAC and a facility equipped for emergencies.
- Share medical history: Provide details of your previous caesarean section, including incision type and reasons for the surgery.
- Create a birthing plan: Discuss preferences and safety measures with your doctor during prenatal visits.
- Educate yourself: Learn about VBAC’s process, risks, and benefits to make informed decisions.
- Seek support: Rely on family, friends, and healthcare professionals for emotional and practical support.
Study on Vaginal Birth After Caesarean Section
A study from the Indian Journal of Medical Specialities explored how likely you are to have a successful vaginal birth after a caesarean if you’ve had one previous caesarean section.Conducted over a year in India with 77 pregnant women at term, the study created an easy-to-use scoring system (ranging from 0 to 22) to predict your chances of a successful VBAC. It looked at factors like:
- Your body mass index (BMI)
- Number of previous births
- Cervical readiness (Bishop’s score)
- Whether labour starts naturally
- Reason for your prior caesarean
- Your BMI is 30 or less
- You’ve had three or fewer prior births
- Your cervix is favourable, meaning your Bishop’s score is above 4
- Labour begins on its own
- Your previous caesarean was for a non-recurring issue like foetal distress rather than labour not progressing
Key Questions to Ask Your Doctor
Ask your healthcare professional the questions mentioned below about VBAC and repeat caesarean sections.- Past deliveries: What were the reasons for my previous caesarean section?
- Incision type: Was my caesarean section incision low transverse or another type?
- Safety: Is VBAC safe for me and my baby based on my health and pregnancy?
- Facility capabilities: Can the hospital handle an emergency caesarean section if needed?
- Labour induction: Will induction be necessary, and how does it affect VBAC safety?
- Future pregnancies: How will VBAC or a repeat caesarean section impact my plans for more children?
VBAC can be a safe and positive choice if your health and pregnancy allow it. Remember to discuss your medical history and concerns openly with your doctor and take time to understand the risks and benefits before deciding. VBAC can provide a fulfilling birth experience for you and your baby with proper care and support.
FAQs on Vaginal birth after caesarean section (VBAC)
- Can I try VBAC if I have had more than one caesarean?
Yes, in some cases. If you've had only one or two low transverse caesareans and no other complications, VBAC may still be possible. - Is VBAC safe for me and my baby?
It can be, depending on your health, the reason for your previous caesarean, and your current pregnancy. A detailed medical evaluation is necessary. - How does VBAC affect future pregnancies?
VBAC may reduce the risks linked with multiple caesareans, such as placenta previa or accreta, which can cause complications later.
