Vaginal Birth After Cesarean (VBAC)

Many people view the act of giving birth as being just about the baby. But it is not! Childbirth is as much about the new life as it is about you, the mother. Your desires and your wishes do matter. So, if you want to give birth naturally though your previous was a cesarean birth, you have the right to plan and hope for a VBAC.

A c-section can be a lifesaver, but for some people, it can also leave that personal touch out of childbirth. There are many reasons women need surgery to give birth, and none of them are trivial.

If you had a cesarean but now want to opt for a VBAC, your work is cut out for you! Let us give you all the scoop on VBAC.

Why should you even try for a VBAC?

You had a Cesarean last time, and your baby came out healthy and happy. So, why rock the boat this time around? There are many reasons you and so many other women worldwide contemplate a VBAC. Here are some of the major reasons:

• Faster recovery is one of the biggest reasons women opt for VBAC. With a little one at home already and another one about to make their entry into the world, the last thing you need is to hobble around in pain.
• For many women, a cesarean birth feels impersonal and takes away some of the early chances for bonding with their newborn. If that is how you felt about your previous delivery, VBAC may be right up your alley.
• Breastfeeding is one of the most beautiful aspects of giving birth. But a c-section can make breastfeeding difficult. A VBAC can help you establish an early breastfeeding bond with your newborn.
• Once a c-section, always a c-section! For a long time now, a cesarean birth marked the end of any possibility of a natural delivery in the future. If you are planning to have more than two kids, remember that each c-section makes the chance of a VBAC dimmer.
• It may feel irrational to others, but how you want to give birth is entirely your choice. So, a VBAC is a good idea just because you want to experience a natural birth!

What are the risks associated with VBAC that you should know about?

A natural birth may be your dream, but the ultimate aim of childbirth remains a healthy baby and a healthy mother! That is why it is important that you know about all the risks associated with VBAC before you jump on the bandwagon.

• The biggest reason doctors are wary of encouraging a VBAC is a uterine rupture. If you had a uterine rupture during your previous delivery, you should not even attempt a VBAC this time around – yes, it is that risky. But if you had a relatively healthy, low transverse (bikini) cut cesarean, your chance of getting a uterine rupture is as low as 0.5% to 1% (depending on other health issues).
• A uterine rupture can cause infection and brain damage to the baby.
• In some extreme cases, a uterine rupture can also necessitate a hysterectomy (removal of the uterus). Remember that a partial hysterectomy does not cause immediate menopause but will leave you infertile.
• In most cases, the worst that can happen during a VBAC is a failed labor process and an emergency c-section.

What different factors determine the success rate of a VBAC?

You’ve seriously considered the risk factors as they relate to your specific circumstances and still want to opt for VBAC? Good for you! In fact, studies show that a good percentage of women (60% to 80%) go on to have a successful vaginal delivery via VBAC. Some of the factors that determine the success rate of a VBAC attempt include:

• Check your previous c-section scar. If you had a low transverse uterine incision last time, you have a good chance of having a successful VBAC. But if you have had more than one c-section, your chances will go down.
• If your pregnancy is progressing smoothly and none of the factors that led to a cesarean last time exist during your current pregnancy, a vaginal birth is no longer a dream for you.
• If you go into labor without assistance before or on your due date, you are on track for a VBAC. But if you are already past your due date, the chance of a natural delivery will dip.
• Another factor that can make VBAC difficult is macrosomia; that is, if your child is larger than usual.
• According to studies, your age too can play a significant role in VBAC. Younger mothers are more likely to come out of a VBAC successful and without complications. But if you are 35 or above, you are 39% more likely to experience complications and a failed labor trial during VBAC.
• Your race is also a factor that determines the success rate of a VBAC. White women are more likely to have successful VBACs than women of other races. But the good news is that non-white women are 40% less likely to experience uterine rupture during a VBAC.
• Obese women are 50% more likely to have a failed VBAC when compared to underweight women.

How can you prepare for a successful VBAC?

If your heart is set for a VBAC, start planning for it. There are things you can do to increase your odds of a successful VBAC.

• Research, research, and research some more! If you are going for a VBAC, make sure you know the ins and outs of it. You can even take VBAC childbirth classes along with your partner.
• Talk to your doctor about your wish for a vaginal delivery and discuss your complete medical history with him. Many doctors try to talk women out of a VBAC. But unless there is a good reason, hold your ground. If your health care provider is not supportive of a VBAC, look for someone who is!
• Look for a hospital that is not just supportive of a VBAC but also has a high success rate in it. The hospital should also be well-equipped to handle any emergency situation.
• Despite popular belief, your doctor can induce labor during a VBAC. But it will be best if things kick-start naturally. So, allow your body to go into labor naturally.
• If you are obese, talk to your doctor about the risks while opting for a VBAC. In fact, it will be a great idea to lose some weight before you become pregnant!
• Eat well and exercise regularly. A healthy pregnancy is surely a plus if you are trying for a VBAC.
• Most importantly, be ready for a c-section! No matter how perfect everything is moving, the slightest of problems may warrant an emergency cesarean.

“Birth is not only about making a baby. Birth is also about making mothers – strong, capable, competent mothers who trust themselves and know their inner strength”. Barbara Katz Rothman

Remember this beautiful quote whenever you find yourself doubting your body. Trust your body and your doctor.

A VBAC can make you feel powerful and strong, reaffirming your inner warrior! But even if you do end up with another cesarean, remember, being a mother itself is a victory. Giving birth is only the first step, you have a whole battle lined up. So, plan a VBAC if it’s right for you but don’t let it take over your life.

Featured photo credit: VBAC via flickr.com