Vaginal Birth After A Cesarean Section
It used to be that once you had a cesarean section, you always had to deliver your children in that fashion. Nowadays, many women are able to choose between having a repeat c-section and delivering vaginally after a cesarean.
What is VBAC?
Vaginal Birth After Cesarean is what VBAC stands for. It is a vaginal birth after one or more cesareans. More than 80% of women will be able to have a VBAC. VBAC is safer than repeat cesarean and VBAC with more than one previous cesarean does not pose any increased risk.
Tips for a Healthy Vaginal BirthUse these tips to help ensure your VBAC goes well.
More VBAC Tips
Why Would I Want a VBAC?
Every woman has a different reason for wanting a vaginal birth after a cesarean. For some, the justification may be medical and while other women feel an emotional need to give birth vaginally. For others still, the cause may be financial or in terms of recovery.
There are numerous benefits of a vaginal birth. For mothers, these benefits include:
- Reduced risk of maternal death
- Fewer complications
- Prevention of blood loss, infection, blood clots in legs and injury (bowel, urinary tract, etc.)
- Breastfeeding is generally easier after a vaginal birth
- The cost of a vaginal birth is about $3,000 less
- Prevention of Iatrogenic Prematurity (meaning surgery was done because of an error in guessing a due date)
- Reduced chance of Persistent Pulmonary Hypertension
- Prevention of surgery related fetal injuries (lacerations, broken bones)
- VBAC results in fewer fetal deaths than elective repeat cesareans
A common fear among women who have had a previous cesarean is rupturing of the uterus. Most of this fear dates back to when the incisions of the original cesarean were of the classical variety (vertical incisions). There are two types of uterine rupture: complete and incomplete.
Complete uterine rupture is very unlikely today for a variety of reasons. First, if pitocin is used during labor, the amount is regulated. Previously, it was administered through IV to a woman and allowed to flow freely. Secondly, because of the rarity of vertical incisions, the number of ruptures has lowered. Nowadays, most incisions are the low transverse type, which means the incision is made across the lower part of the uterus. A complete rupture occurs in less than 1% of women attempting VBAC.
Incomplete rupture occurs about 1-2% of the time. However, usually these women are asymptomatic, and neither mother nor infant require any assistance.
Am I a Candidate for VBAC?
Whether or not you will be able to try VBAC will depend on several things. These include:
- Low transverse incisions on both the abdomen and uterus from previous cesarean. If you had a low-transverse uterine incision, as 95 percent of women do today, your chances of having a VBAC are good. However, if you had a classic vertical incision down the middle of your uterus, you will probably not be allowed to attempt a vaginal delivery because of the possible risk of rupture of your uterus.
- Adequate pelvis
- Reason for previous cesarean. If the reason that you had the previous cesarean was something that is not likely to repeat during this pregnancy, such as infection, drug or alcohol abuse, preeclampsia etc., you are a good candidate for VBAC. If, however, the reason for your cesarean was a chronic illness that is likely to impact your current pregnancy, such as high blood pressure or diabetes, you will probably require a repeat cesarean.
- Willingness to prepare for VBAC
Every woman has a different reason for wanting (or not wanting) a VBAC birth. Want to share your story about VBAC to help other women in their decision? Then visit Pregnancy Stories to post your experience with VBAC.
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