Vaginal Birth after Cesarean (VBAC)

Once a cesarean, always a cesarean! Not necessarily although this issue is still under scrutiny because of the uncertainties involved. That explains the low percentage of woman opting to give birth vaginally after a cesarean. Many medical practitioners are still divided; some are not totally for it though there are some who are. Vaginal birth after cesarean or VBAC is possible but not without some considerations you will have to take into account.

• You will have to go through labor or what is largely known as a trial of labor.
• Your previous incision was a low-transverse one
• You do not have any other uterine scars or surgery of the uterus
• You should not attempt home delivery because it is important to have medical support to monitor you during active labor.
• Your baby will need to be electronically monitored throughout
• You will need an IV and will need to fast during labor
• If things do not go as per plan, as may be the case in some situations, a cesarean can be readily performed; the hospital you are warded at should be able to arrange an emergency surgery.

The advantages of a VBAC after a C-section are many. The most important being the safety issue as no surgery is involved; with every surgery there is a risk element. Others include:

• More energy after childbirth
• Newborns face fewer breathing problems and respiratory issues
• Fewer blood transfusions as there is less bleeding
• Risk of infection and fever episodes are much lower
• A shorter stay in the hospital
• A faster return to routine activities

The Downside to a repeat C-section

• The risk of infection and injury to the mother increases - the organ most susceptible is the bladder.
• Risk to newborns also rises
• Very close monitoring is required during the procedure and after because of the possibility of having the uterine scar separate or worse still if it ruptures.
• The stress VBAC puts on the previous incision site
• Longer recuperation period and stay in the hospital

VBAC is best avoided

• If the incision made previously was a vertical or T-shaped one, more popularly known as the classical cut
• If you have never delivered vaginally and had more than one cesarean
• If it is a multiple pregnancy
• If your pelvis is too narrow to accommodate a vaginal birth
• If baby is larger than normal
• If you are two weeks past your due date
• If baby is not positioned head downward
• If your hospital is not well-equipped to perform an emergency c-section

However VBAC is still viable if you faced placental abruption in the past, had a breech baby previously or your baby had experienced fetal distress in your previous pregnancy.

Foot Note

An elective or a planned cesarean is safer with fewer recovery problems than an emergency one. A woman attempting VBAC can end up having an unplanned c-section despite enduring hours of labor. This is one other reason why women choose to go for a repeat c-section apart from the dangers of a uterine rupture. Whatever you decide it is best to be as familiar as you can be with VBAC issues, your previous medical records and discuss the pros and cons with your healthcare provider.