If you delivered through a C-section in your previous pregnancy, you may have an option of a repeat c section or a vaginal birth after a cesarean (VBAC). VBAC is possible in many situations today unlike years ago, due to changes in surgical techniques. However, it should be noted that VBAC is not for everyone. A pregnancy complication or an underlying medical condition may make it impossible for a vaginal birth after cesarean.
Who is a good candidate for VBAC ?
You may have the option of a VBAC if you meet all the following criteria.
- you’ve had only one cesarean incision that was a low-transverse uterine incision (horizontal incision)
- you have no uterine abnormalities, scars or rapture
- baby is normal size
- baby is not breech
- you have no serious medical problems
- the reason for your previous c section is not a factor
- labor begins naturally on or before your due date
- if the physician available can monitor labor as well as perform an emergency cesarean if need be
- if birth location have personnel available on weekends and evenings in case a cesarean is necessary
A VBAC is less likely to be successful if
- you are overweight
- you are an older woman
- baby is unusually large
- you are past your due date
- you are expecting multiples
- you have an underlying medical conditions such as diabetes and high blood pressure
- you’ve had to or more cesarean deliveries and no vaginal deliveries
What are the benefits of a VBAC ?
Vaginal delivery after cesarean have the following benefits
- avoids a major abdominal surgery
- shortens postpartum recovery
- reduces a woman’s risk of infection
- reduces a woman’s risk of hemorrhage
- it helps a woman avoid future risks of multiple c section such as placental problems, hysterectomy, bladder and bowel injury, blood transfusion and infections.
What are the risk associated with a VBAC ?
The main concern for a VBAC is uterine rapture. According to the American College of Obstetricians and Gynecologists ,the risk is between 0.7% and 0.9%. Even though this number is low, a uterine rapture is a medical emergency and may cause injuries to both mother and baby.
Other risks associated with vaginal delivery after cesarean include the following
- failure of labor to progress
- increased risk of surgical complications such as excessive bleeding or uterine infection if you have an unplanned c section after labor has already started
- pelvic floor problems such as temporary urinary incontinence
NOTE
During a VBAC, you will be closely monitored for any signs of fetal distress. You will not be allowed to eat anything during labor, just in case you need an emergency c section.
Content Sources
New VBAC guidelines. The American College of Obstetricians and Gynecologists (ACOG) . http://www.acog.org/-/media/ACOG%20Today/acogToday0810.pdf?dmc=1&ts=20141009T0757462625. Accessed October 8, 2014
What is vaginal birth after delivery VBAC .WebMD. http://www.webmd.com/baby/guide/vaginal-birth-after-cesarean-vbac-overview. Accessed October 8, 2014
Vaginal birth after cesarean VBAC. Mayo Foundation. http://www.mayoclinic.org/tests-procedures/vbac/basics/definition/prc-20020457. Accessed October 9, 2014