A vaginal delivery after caesarean may be an option if you’ve had a previous C-section and are now expecting a second child (VBAC).
Attempting a trial of labour after caesarean section (TOLAC) is a viable option for many women. When women in the United States undertake a trial of labour after having a caesarean, the success rate is 70 percent.
However, not everyone is a good candidate for VBAC. If you have a scar on your uterus that is considered high-risk, a VBAC may not be a choice for you. Hospitals that don’t have the staff or resources to do emergency C-sections don’t provide VBAC. Any questions you have about whether or not you’re a good candidate for a VBAC can be answered by talking to your doctor.
Why it’s done
• Impact on future pregnancies, which is a common reason for opting for a trial of labour after caesarean. Multiple caesarean births carry complications such as placenta previa and placenta accreta, which can be avoided with VBAC.
• Lessening the possibility of surgical problems. Lower risks of heavy bleeding, infection and blood clotting in one or more deep veins of the body are connected with VBAC success (deep vein thrombosis). Additionally, VBAC may reduce the risk of hysterectomy (surgical removal of the uterus) and abdominal organ harm (such as the bladder or intestine).
• Less time spent recovering. A VBAC results in a shorter hospital stay than a repeat C-section. You’ll be able to get back to your usual routine faster if you don’t have surgery.
• The ability to create a unique birth plan. Vaginal birth is a priority for some expectant mothers.
In several cases, you may be a candidate for a VBAC:
• In order to be eligible for a VBAC, you must be pregnant with one child, have a history of one or two low transverse C-sections, and have no medical conditions that would prohibit you from doing so
• Have had a past C-section with an uncertain uterine incision type, but no other issues that would exclude a VBAC, unless it is thought that you previously had a high vertical (classical) uterine incision.
• For some women who are pregnant with twins and who have previously had a low transverse C-section, twin vaginal birth is an option.
• Prior vaginal birth is the most reliable predictor of a successful VBAC.
A medical condition that would exclude a vaginal birth, or a history of the following, disqualifies you from a VBAC:
• A previous uterine incision that was high and vertical (classical).
• It’s believed that the preceding uterine incision was a high vertical (classical) incision, however this is not certain.
• When the caesarean scar on the uterus tears open, it is known as a uterine rupture.
• Previous uterine surgery, such as the excision of a fibroid.
• If you’ve had more than two C-sections or a BMI of 50 or more at the time of birth and have never had a vaginal delivery, you may not be eligible for a VBAC. If you’re expecting triplets or more, you’re unlikely to be able to have a VBAC.
Factors that reduce the chance of a successful VBAC include:
• Stagnant work force
• Maternal age that is too old
• Pregnant women who are more than 40 weeks along in their pregnancy
• BMI of 40 or above is considered obese
• Pregnancy weight gain that is excessive.
• Preeclampsia
• Within the last 18 months after delivery
• Prior C-sections and no vaginal births are required.
• A closed cervix necessitates labour induction.
Risks
VBAC is less risky than elective repeat C-sections because of the lower risk of complications, but a failed attempt at labour after caesarean is more likely to result in problems, including uterine rupture. C-sections are necessary if the scar from a prior caesarean breaks open during a trial of labour to prevent life-threatening complications for both mother and baby. The uterus may need to be surgically removed as a treatment option (hysterectomy). You won’t be able to become pregnant again if your uterus is removed.
How you go about it
VBAC may be discussed at your first prenatal appointment if you’ve had a prior caesarean section. Consult with your doctor or other medical professional about your worries and hopes. If you’ve had a previous C-section or other uterine treatment, make sure your doctor knows about it. A successful VBAC may be predicted based on your past medical history, which your doctor can utilise to make that prediction.
Also, make arrangements to have your baby delivered through emergency C-section in a facility that is prepared for this scenario. Throughout the pregnancy, address the risks and advantages of VBAC, especially if specific risk factors occur.
Expectations for the future
Your labour will proceed in the same manner as any other vaginal birth if you opt for VBAC. Your doctor will probably recommend that you keep an eye on your baby’s heart rate at all times and be ready to perform another C-section if the necessity arises.
Which women can benefit from vaginal birth after caesarean section (VBAC)?
• In order to be eligible for VBAC, a number of things must be taken into consideration. What sort of uterine incision was utilised during the last C-section, for example: A low transverse incision is used in the majority of C-sections. Women who have had a low transverse or low vertical incision are typically good candidates for a VBAC procedure. A VBAC is not suggested if you’ve had a previous high vertical (classical) incision.
• Have you suffered a uterine rupture before? If this is the case, you are ineligible for VBAC.
• Have you undergone any additional uterine surgeries? VBAC is not indicated if you’ve had previous uterine surgery, like as for fibroid excision.
• Have you ever experienced a vaginal birth before? In order to have a successful VBAC, it is recommended that you have had at least one vaginal birth before or after your prior C-section.
• Your total number of caesarean sections is: If you’ve had more than two previous C-sections, your doctor may not be willing to perform a vaginal birth after caesarean.
• How many children have you had? If you try a VBAC fewer than 18 months after your previous delivery, the risk of uterine rupture is greater.
• A vaginal birth may not be possible if you have any underlying health issues. C-sections are indicated for women who have placental difficulties, have babies that are in an aberrant posture, or who are carrying triplets or multiples of a higher order.
• Where are you planning to give birth? Make arrangements to give birth in a facility that is prepared to perform an emergency C-section. A vaginal birth after caesarean is not recommended for women undergoing a VBAC.
• Are you going to have to be induced? The probability of a successful VBAC is decreased when labour is induced.
What are the differences between a VBAC and a normal vaginal birth in terms of labour and delivery?
If you choose for a VBAC, you’ll go through the same process as any other vaginal birth when you go into labour. But your doctor would probably advise you to keep an eye on your baby’s heart rate and be ready to do another C-section if necessary.
What other words of wisdom do you have for ladies thinking about a vaginal birth after childbirth?
If you’re considering a VBAC, talk to your doctor about your worries and expectations as soon as as. If you’ve had a previous C-section or other uterine treatment, make sure your doctor knows about it. The chance of a successful VBAC can be estimated by your doctor.
Also, make arrangements to have your baby delivered through emergency C-section in a facility that is prepared for this scenario.
Throughout the pregnancy, address the risks and advantages of VBAC, especially if specific risk factors occur.
Keep an open mind above anything else. Depending on the conditions of your labour, you and your health care practitioner may decide that a repeat C-section is the best option for you and your baby.
People also search
What are the risks of natural birth after C-section?
In contrast to an intentional repeat C-section, a successful VBAC has less problems, while a failed trial of labour after a C-section has higher complications, including rupture of the uterus. More than one percent of women who try vaginal birth following caesarean delivery will experience uterine rupture; nevertheless, this is extremely uncommon.
How long do you have to wait after AC section to have a vaginal birth?
Your doctor or midwife may tell you to hold off for a further 12–18 months after waiting the minimum of six months. The stronger your scar will be the longer you let it to heal. If you plan to have a vaginal delivery in the future, you must ensure that your scar is entirely healed.
How can I avoid a second C-section?
• Avoid becoming hungry, but also avoid going too
• Get lots of exercise.
• Attend birthing classes.
• Take the baby for a drive if he or she is breech
• Take a deep breath and let go
• Stay away from artificial inducement of labour
• Doula or labour coach may be an option to consider
• Maybe you should put off getting the epidural.
