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VBAC Birth: All Your Questions Answered

Have you heard the term VBAC floating around? Maybe you know it’s something to do with child birth but are otherwise clueless. Well, wonder no more because you are in exactly the right place to learn all about it …

What is a VBAC birth?

VBAC stands for “Vaginal Birth After Caesarean Section.” It refers to a woman giving birth vaginally having previously undergone a Caesarean Section (C-section) for a previous birth.

Who might choose a VBAC birth?

Anyone who has previously had a C-section may wish to have a vaginal birth for future pregnancies. This could be for a whole range of reasons, including the simple desire to just experience a vaginal birth a shorter recovery time, and the potential to have more children without undergoing multiple C-sections.

Whether or not you’re suitable for a vaginal birth depends on several factors, including the type of uterine incision from your previous C-section, the reason for the prior C-section, and the overall health of mum and baby, as well as the policies of the hospital and/or birthing facility.

How to decide whether to have a VBAC birth?

Deciding whether to have a vaginal birth is a complex and personal decision that should be made following discussions with your midwife, obstetrician and medical team. In coming to a decision it’s important to firstly educate yourself about the risks and benefits of a VBAC birth and the relevant factors that make you a good candidate (we’ll explain all below). Talk to your midwife and ask any questions you may have about the process, including the risks and benefits of a planned C-section.

You don’t have to rush into any decision so take some time to reflect on your birthing preferences, values, and emotions surrounding childbirth. Think about your previous birth, how you felt during the birthing process and what you want to repeat and / or avoid this time around.You may find it helpful to discuss your previous birth to learn more about why a C-section was needed and whether those factors impact your decision for your next birthing experience.

It’s important to be honest with yourself about your wishes as well as your personal tolerance for risk, including your ability to handle any potential complications that might arise. Be sure to discuss your thoughts and concerns with your partner or other close family members. Having emotional support during the decision-making process can be really valuable and help put things in perspective.

What are the risks of a VBAC birth?

While a vaginal birth is generally considered a safe option for many women who have had a previous C-section, it’s important to recognise that it still does carry some degree of risk. These are a few of them:

  • Uterine rupture: This is the most serious risk. It occurs when the scar from the previous C-section tears during labour, leading to the opening of the uterus. Uterine rupture can cause severe bleeding, endangering the life of both the mother and the baby. However, it is relatively rare, occurring in about 0.5% to 1.5% of VBAC attempts.
  • Emergency C-section: If complications arise during labour or the VBAC attempt, an emergency C-section may become necessary. Factors such as labour not progressing adequately, baby in distress, or signs of uterine rupture may lead to the need for an immediate C-section.
  • Placental issues: Women attempting a vaginal birth may have a slightly higher risk of placenta-related problems, such as placental abruption.
  • Perineal tears or injury: Like with any vaginal delivery, there is a risk of vaginal tears or other injuries during the birth process, which can require stitches and may result in discomfort during the recovery period.

What are the benefits of a VBAC?

There are several potential benefits for women who choose to have a vaginal birth, including:

  • Avoiding major abdominal surgery: A vaginal birth allows women to avoid the risks and potential complications associated with a repeat C-section, which as we all know is *major* abdominal surgery. Recovering from a vaginal birth is generally faster and involves less postoperative pain compared to recovering from a C-section.
  • Shorter hospital stay: Following a vaginal birth, the hospital stay is typically shorter than after a C-section. This means you’ll be more likely to return home and resume normal activities more quickly, which can be beneficial for both physical recovery and bonding with the baby.
  • Reduced risk of infection: Vaginal births generally have a lower risk of postpartum infections compared to C-sections. The risk of surgical site infections and other complications related to the abdominal incision is avoided with VBAC.
  • Potential for future vaginal deliveries: A vaginal birth can increase the chances of having subsequent pregnancies and births vaginally. Avoiding multiple C-sections may be beneficial for long-term reproductive health and family planning goals.
  • Improved breastfeeding experience: Some studies suggest that women who have vaginal births may experience fewer challenges with breastfeeding compared to those who have undergone C-sections. This may be related to hormonal and physiological differences between the two birthing methods.
  • Psychological and emotional benefits: For some women, achieving a successful vaginal birth can be an empowering and positive experience. It may help boost self-confidence and create a sense of achievement in overcoming previous birthing challenges.

Ultimately, the decision to attempt a vaginal birth or opt for a repeat C-section is yours to make. Once you have gathered all the necessary information, take the time to think about what feels right for you and your baby. Remember that every pregnancy is unique, and what was right for a previous pregnancy may not apply to the current one.

What is the recovery like after a VBAC birth?

The recovery after a successful VBAC birth can vary from person to person, but in general, it is often easier and quicker compared to the recovery after a C-section. In many cases, women who give birth vaginally may be able to go home within 24 to 48 hours, depending on the hospital’s policies and the mother and baby’s health. You will also likely find that you are able to move around more freely and independently soon after delivery, which can speed up the overall recovery process.

Whilst a VBAC birth does not involve major abdominal surgery, you should still expect to experience some discomfort and soreness in the vaginal and perineum area. As with any vaginal birth, there is still the risk of experiencing a perineal tear or requiring an episiotomy. Check out these articles for more on perineal massage and avoiding tears.

What is the likelihood of needing a C-section if I attempt a VBAC?

Generally, the chances of a successful vaginal birth after a C-section are around 70% to 75%, which means that in about 25% to 30% of cases, an emergency C-section might be needed during the VBAC attempt. Several factors can influence the likelihood of needing a C-section during a VBAC, including:

  • Previous C-section type: The type of incision in your belly from the previous C-section plays a significant role. Women with a horizontal scar typically have higher success rates for VBAC compared to those with other types of scars (e.g., vertical).
  • Gestational age: Studies have shown that being at least 37 weeks pregnant (or more) makes the woman a better candidate for VBAC.
  • Baby’s position: The baby’s position during labor can affect the feasibility of a successful VBAC.
  • Hospital guidelines: The practices of the hospital can influence the likelihood of a VBAC as they will have their own policies and resources to consider.  

During the labour and delivery process, midwives and obstetricians will continue to closely monitor both the mother and the baby to ensure a safe and positive outcome. If complications arise or if there are signs of potential risks to the mother or baby, a C-section may be recommended to ensure the well-being of both.

Is a VBAC safer than repeat C-section?

This is a tricky one to answer as it will really depend on your personal circumstances, including your own medical history, the specific circumstances of the current pregnancy, and the expertise of the healthcare providers involved. In general though, both VBAC and repeat C-section can be safe options when managed appropriately and with appropriate medical care.

Is a VBAC like a first-time vaginal birth?

VBAC and a first-time vaginal birth share some similarities, but there are also some pretty key differences between the two experiences.

The similarities are fairly obvious. Both VBAC and a first-time vaginal birth involve the process of giving birth vaginally, with the baby passing through the birth canal. Both experiences also typically involve the same stages of labour, including early labour, active labour, transition, and pushing during the second stage.

The most significant difference is that VBAC occurs after a woman has had a previous C-section, whereas a first-time vaginal birth is the first child birth experience without any prior C-section surgery. This mean that you’ll probably be bringing in some expectations and worries from your first birth to this subsequent birth. You’ll also likely need increased monitoring during a VBAC due to your previous C-section scar to minimise the risk of it rupturing whilst in labour.  

In both cases, having a supportive midwife and medical team is crucial. Ask your midwife about how often VBACs happen at the hospital or Trust where you’ll be giving birth and the level of experience of those who will be looking after you.

Is it safe to use a birthing pool during a VBAC?

The use of a birthing pool during VBAC is generally possible and can be a safe option for some women. However, it will depend on the local policies and specific guidelines at your hospital and / or birthing centre. As we mentioned above, you’ll also need to be monitored more closely because of your C-section scar and so any monitoring equipment will need to be effective in water.

Ultimately, the decision between VBAC and a first-time vaginal birth depends on a person’s individual medical history, the reason for the previous C-section, and other relevant factors. If you have your heart set on a VBAC, be sure to discuss all your concerns with your midwife and be open to hearing the options available to you so can make an informed decision that aligns with your specific wishes.

Sources:

https://www.cmaj.ca/content/190/18/E556

https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/birth-after-previous-caesarean-birth-green-top-guideline-no-45/

Birthbabe does not provide medical advice, diagnosis, or treatment. The resources on our website are provided for informational purposes only. You should always consult with a healthcare professional regarding any medical diagnoses or treatment options. 

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