If you have had a cesarean delivery, your doctor or midwife may suggest trying a trial of labor after cesarean (VBAC). VBAC may provide safer and more natural delivery than repeat C-section.
However, during labor there is always the risk that the scar in your uterus could break open – this is known as uterine rupture and it could prove deadly for both mother and baby.
Reasons to Try VBAC
Once it was believed that women who had experienced cesarean sections would always need one in subsequent pregnancies, but over 60 to 80% of women attempting vaginal birth after cesarean (VBAC) succeed in having their babies vaginally. Talk to your healthcare provider early in pregnancy to see whether VBAC may be appropriate.
VBAC presents several risks. Uterine rupture can occur when your scar opens during labor and could potentially endanger both you and your baby’s lives. Although rare, this risk should not be taken lightly and should be managed accordingly.
To reduce this risk, doctors are now cutting different parts of the uterus when performing VBACs and they limit how often this procedure should be attempted to two pregnancies at most – this is because repeat cesarean procedures increase complications risk exponentially with each gestation.
Other factors that could impede your chances of a VBAC include how many C-sections you’ve had previously and what kind of incision was used during previous C-sections; having had one with a high vertical incision that cuts up and down through strong laboring muscles increases your risk for rupture during a VBAC, while health complications or pregnancy-related issues (like placenta previa or abnormal positioning of your fetus) might make a VBAC impossible.
Induction of Labour
There is a very slight risk that during labor, your scar may tear or rupture during VBAC, known as uterine rupture. It occurs about once out of 200 birthing mothers choosing this delivery option and it should only happen occasionally; nonetheless it has serious repercussions for both mother and baby and therefore doctors and midwives should closely monitor your VBAC journey for possible complications that might arise; hospital birth is highly advised as hospitals are best equipped to manage complications that arise during delivery.
VBAC may help reduce your chances of repeat cesareans during future pregnancies and can result in shorter hospital stays and faster returns to regular activities after birth. Furthermore, having skin-to-skin contact shortly after giving birth allows for bonding and breastfeeding opportunities.
Communication between you and your obstetrician during gestation is vital in order to make informed decisions regarding VBAC and vaginal delivery. Your doctor can advise on your eligibility for VBAC as well as help decide when it’s safe. Your decision might not receive as much support if your previous cesarean was due to complications during labor such as breech presentation or dystocia (long and difficult labor). Furthermore, every subsequent cesarean increases the risk of uterine rupture.
Vaginal Delivery
VBAC allows your baby to enter the world vaginally, offering numerous advantages for both you and her. Babies born vaginally tend to require less time in special care nurseries due to breathing issues or health concerns, have better immune responses due to being exposed to hormones released during labor and more of the beneficial bacteria through mother’s womb exposure.
Once upon a time it was believed that having had one cesarean would mean always needing another cesarean (C-section), but today most women who have previously undergone cesareans can give birth vaginally if safe to do so based on prenatal care evaluations and evaluation of individual circumstances.
If your previous C-section was due to dystocia (difficult labor), or you were fully dilated when labor stalled and you needed an emergency C-section as a result, a VBAC may be possible. This is particularly relevant if it happened before full dilation occurred resulting in C-section.
Women seeking to have a vaginal birth after having had a cesarean should consider VBAC as an option. With proper counseling to assess both benefits and risks, women can make their decision whether VBAC is right for them. Due to its increased risk of rupture for this population, only attempt VBAC at facilities equipped for emergency situations when considering this method of delivery.
Postpartum Care
C-section increases your risk of placental insufficiency or infection in later pregnancy. With VBAC, however, you avoid surgery altogether and may be able to have a shorter hospital stay and recover more quickly – plus the added bonus of experiencing vaginal childbirth which many women find important! Plus if you plan for multiple cesarean deliveries this could also help.
Prior to recent times, most doctors advised women who had had prior cesareans that vaginal birthing may not be possible for them. Now however, many pregnant women who attempt a vaginal delivery succeed; these individuals may qualify as VBAC or TOLAC candidates.
One major risk associated with VBACs is uterine rupture at the site of your previous C-section scar. Studies, however, show that this risk is low among women who have already undergone one C-section with low transverse incision.
If you are considering having a VBAC, be sure to discuss it early with your healthcare provider. A medically managed pregnancy requires being closely monitored throughout gestation and delivery by healthcare providers; additionally, hospital delivery offers more safety should complications arise, such as uterine rupture.
