There may be some women who want to have a natural childbirth after having a cesarean delivery in the previous pregnancy.
This can be due to a multitude of reasons: wanting a more affordable delivery process, a faster postpartum recovery period, or as simple as wanting to know how giving birth naturally feels like.
There are some assumptions that women who have had a cesarean delivery will not be able to give birth normally – that is not exactly true. There is such a thing as vaginal birth after cesarean (VBAC), which is a normal delivery procedure after having a C-section delivery.
However, not all women can have a VBAC.
You will need to consult an obstetrician & gynaecologist (OBGYN) if you want to find out for sure whether you can have a VBAC. The specialist doctor will analyse your medical condition as well as your baby’s.
What is VBAC?
Vaginal birth after cesarean (VBAC) is a term used for a normal birth procedure after a person has had a cesarean section or c-section delivery in the previous pregnancy.
According to the American Congress of Obstetricians and Gynecologists (ACOG), the VBAC method is a safe and suitable option as it has a high success rate.
Moreover, according to WebMD, a study showed that about 75% of women successfully undergo VBAC procedures. The same study also showed that the postpartum complication rate is lower than pregnant women planning a second caesarean section.
It is important to know that VBAC can work well in women who have had one cesarean section.
You need to do a series of tests to determine if you are an ideal candidate to undergo the VBAC procedure. That said, it is important to be aware of the potential risks of VBAC.
Candidates for VBAC
There are several medical requirements for a VBAC procedure. The factors influencing the success of VBAC include:
Indicators to Undergo VBAC
- Your baby is head down.
- Your baby has a normal weight
- You have had a successful natural delivery before
- You have a fairly large pelvis, which means you have a larger birthing canal
- You have a horizontal scar on the lower part of the abdomen from the previous caesarean section.
- You have never had a uterine rupture in the previous pregnancy.
- Your labor starts spontaneously after induction which makes the contractions become stronger and faster.
- You do not have any chronic medical conditions that may affect the success rate of VBAC – such as fibroids and placenta previa.
- You have never had any major surgery on the uterus, such as a myomectomy to remove a benign tumor (fibroid) from your uterus.
- You are currently pregnant and have a history of one cesarean section, but not with a vertical or a T-shaped incision in the abdomen.
- You are currently pregnant with twins and have a history of one cesarean section, but not with a vertical or a T-shaped incision in the abdomen.
Indicators to Not Undergo VBAC
- You have had more than two caesarean deliveries
- You have a low body mass index (BMI) during pregnancy.
- You are “small for gestational age” — less than 18 weeks.
- You are currently pregnant with triplets or more
- Your baby is diagnosed with having fetal macrosomia – a baby weighing more than 4,000 grams.
- You have had a caesarean delivery with a vertical or T-shaped incision.
- You have had a uterine rupture in a previous pregnancy.
- You have reached an advanced maternal age
- You have had a previous uterine surgery – which is a surgery to remove benign uterine tumors (fibroids).
- Your pregnancy is more than 40 weeks – which means you require a caesarean delivery
Benefits of VBAC:
Pregnant women should consider the benefits of VBAC, such as:
- Shorter recovery time. You will have a shorter hospital stay after a VBAC than after a repeat C-section. Getting the VBAC procedure will help you resume your normal activities sooner.
- Give an opportunity to give birth normally. For some women, it is important to experience a natural delivery even if it is only once in a lifetime.
- Lower dangerous impacts on future pregnancies. If you are planning to have more children, VBAC may help you avoid the risks of multiple cesarean deliveries, such as placenta previa or placenta accreta..
- Lower risk of delivery complications. Normal delivery reduces the risk of bleeding, blood clots, infection, and injury to abdominal organs such as the bladder or bowel
Risks of VBAC
A successful VBAC procedure is associated with fewer complications than a cesarean section. However, a failed VBAC is associated with the failure of normal delivery.
This failure can cause the uterus to tear (uterine rupture) as the previous caesarean section opens again. If you are dealing with this condition, you are forced to take a caesarean section to prevent further complications including infection, heavy bleeding, and deformed babies.
In some severe cases where a surgery is required to remove the uterus (hysterectomy), you will not be able to get pregnant again.
Preparing For a VBAC Delivery
The first step before deciding to give birth through a VBAC is discussing your plans with your ob-gyn. He or she may check your medical history to calculate the likelihood of having a successful VBAC. It is important to continue discussing the benefits and risks of VBAC before making a decision.
Once you have made the decision, here are some things you should prepare for VBAC:
- Learn what VBAC is, its benefits, risks and labor procedures.
- Plan to deliver your baby in a hospital that is equipped with complete facilities.
- Make sure there are no problems with the placenta or umbilical cord and that your baby’s position is normal
- Wait for labor to begin naturally to lower the chance of a cesarean section
Tips For a Successful VBAC
You will need to do a series of tests and be closely monitored by your doctor if you choose to deliver via VBAC. If you meet the criteria as a candidate, you will need to maintain a healthy lifestyle for a successful delivery. Here are some tips for a VBAC delivery:
- Choose well-equipped hospitals and doctors. Try to find hospitals and doctors who have a history of successful VBAC procedures. This will motivate you to be physically and mentally ready to have a successful VBAC delivery
- Avoid labor induction. Try to avoid induction which stimulates uterine contractions before natural contractions occur. Labor induction can cause the previous caesarean section to rupture. It is best if you go through the labor process as naturally as possible to make it a safer and smoother delivery.
- Exercise regularly. Pregnant women only need to do light exercise to maintain their health and weight during pregnancy. Your health and the health of your baby play a key role before undergoing the VBAC procedure. You can exercise with a gym ball which functions to flex the waist, hips, and vagina areas. This will help facilitate a faster delivery process.
- Boost your self-confidence. The success of VBAC depends on your physical and mental readiness. Try to relax and put your trust in the doctor that will assist you throughout the labor process.
If VBAC is performed successfully, you will increase your chances of having a normal delivery in the next pregnancy.
Planning for a VBAC delivery? Or have questions about VBAC? Leave your question in the comment section below.