written by Graham Hutchings, British gynaecologist who works in Delta hospital in Brussels. See www.gyneco-bruxelles.com for more about Graham and his practice.
If you previously had a caesarean birth and now wish to have a vaginal birth, please do discuss this with your care provider to be sure that he/she fully supports you in your wish.
Remember that should you feel a disconnect between you and your care provider, in terms of your views on VBAC, you are free to change care provide at any time during your pregnancy.
Once a C-section, always a C-section?
Usually, the reason for the first C-section (e.g. breech presentation), is related to that pregnancy alone and is no longer present for a subsequent pregnancy.
In this case you may have the opportunity to try for a vaginal birth provided that there are no other complications.
The decision to try for a ‘Vaginal Birth After Caesarean’ (VBAC) is based on the medical situation but also on your informed decision after full discussion of the risks and benefits of each option.
Risks and benefits of VBAC
Approximately 70% of women who attempt a VBAC are successful. This increases to close to 95% for women who have already successfully achieved a vaginal birth after their C-section.
Unfortunately, prediction of those patients more likely to be able to deliver vaginally is difficult.
The primary benefits of a VBAC include:
- shorter hospital stays;
- less need for blood transfusions; and
- a lower chance of infections as well as the satisfaction of achieving a vaginal birth and the increased ability to look after your newborn baby.
In addition, if you are considering further children, a second C-section will mean that all future babies will be born by C-section whereas a successful VBAC will mean that it is likely that future babies can be delivered vaginally.
The most serious risk associated with VBAC is the possibility of the uterus rupturing at the site of the previous incision. The likelihood of this is less than 1%.
This has been found to be more likely when a woman has had more than one cesarean delivery or may have had an abnormally difficult labor during the current pregnancy.
In order to minimise risks to the mother and the baby, the progress of your labour and condition of your baby is closely monitored and facilities for performing an urgent C-section are close at hand.