When a future mummy is told that she won’t be able to deliver her baby vaginally, one of the first questions that arise is whether she’ll be able to have a VBAC in the future.
A VBAC, that is, vaginal birth after C-section is indeed a possibility, but one that is subjected to several requirements.
It is not possible to know if you will be able to have a VBAC right after your first C-section, but if you intend to get pregnant again and try to deliver vaginally, you will know depending on how that second pregnancy develops. If you were dreaming about having a natural birth and that wasn’t possible due to pregnancy or delivery complications, don’t miss the following lines, because the possibility of a VBAC is there and we’re going to tell you all about it!
What is a vaginal birth after c-section or VBAC?
The name VBAC or vaginal birth after C-section just refers to what the name itself designates: it’s the name received by a natural birth, that is, the baby being born after passing through mummy’s birth canal, when that same mummy had to undergo a C-section with her previous baby.
Many people assume that if you undergo a C-section, the trauma suffered by your uterus due to the surgery will make a successive vaginal birth too risky, but that isn’t always the case. The VBAC is a possibility – It is not the best option for everybody, but if you do want to deliver your next baby vaginally, you can tell your doctor and talk about that possibility.
What are the risks associated with VBAC?
The doctors will decide what’s best in every particular case, so if they say that you can attempt at a VBAC birth, you should be fine. However, there are always some risks there that you need to consider carefully before deciding on it. They are the following:
- There is always the risk of your uterus rupturing where your incision was done, that is, where your C-section scar is. After all, you’ve had a C-section before! However, keep in mind that it is a very small risk, just about 1%. That would imply a severe blood loss, and your baby could suffer as well from some oxygen deprivation.
- You could have to suffer an emergency C-section. While VBAC is possible, it is more difficult than a normal vaginal birth, and the possibility that you can’t manage to do it is there. An emergency C-section always implies more risks than a scheduled one, and you would be more likely to suffer complications during surgery.
- If the VBAC is unsuccessful, there is a remote possibility that the baby will suffer damages as well.
Why is the VBAC done, then? Wouldn’t it be safer to just have a C-section again?
Well, the risks of the VBAC explained above may have scared you, but the good part is that it has tons of advantages as well!
- Yes, there are some risks. But the thing is, a C-section itself is more risky than attempting a VBAC, so if the doctors say you’re in the right condition to do so, you would be choosing the safest way to go.
- The recovery time is shorter than with a caesarean. Of course, your body will still be put under a lot of pressure and will have to make a great effort, but the recovery is faster if there haven't been incisions.
- Avoiding multiple C-sections. Are you planning on having lots of babies? If that’s the case, the VBAC should be the way to go, whenever possible, since multiple C-sections imply further risks. For instance, your chances of suffering from placenta accreta or placenta previa would be greater.
- No surgery! The C-section may seem like a little thing, because it is quite common, but it is not. It is major surgery and has some risks associated to it, like any major surgical procedure.
How can I know if I’ll be able to have a VBAC?
The doctor will evaluate your case and tell you if it is possible for you to attempt a natural birth after C-section. First of all, he will examine your pelvis to see if the baby can pass through, although there is no guaranteed way of knowing. He will also evaluate how large the baby is, since C-sections are usually recommended for the birth of very large babies. He will also evaluate the following:
- Your C-section incision: The chances of suffering a uterine rupture will depend much on how the incision was done. A T-shaped or a “classical” vertical incision are more dangerous. The doctor will recommend the VBAC if the incision was low-transverse, that is, horizontal.
- Previous surgeries or trauma: If you’ve had other kinds of uterine surgery, you won’t be able to do it – even less if you’ve had a uterine rupture before, since it would be too risky.
- Your pregnancy development: If you suffer from any condition that prevents you from having a vaginal birth, whether it is after a C-section or not, you won’t be able to deliver your baby vaginally either.
- Pregnancy is not repeating itself: If you are suffering from a pregnancy complication that you previously suffered, and the doctor considers that it had something to do with the need of having a C-section the previous time, he or she won’t recommend the VBAC.
There are some other factors that may make doctors recommend something other than VBAC, like being overweight or older, or if the previous pregnancy was less than 18 months before.
Once the doctor has evaluated that you’re apt, they will also need to make sure that the hospital has the adequate personnel to perform an emergency C-section if necessary: another doctor and an anaesthesiologist.
Ok then, I want to give it a try. What should I expect from a VBAC?
Giving birth after C-section will require some extra preparation to make sure that everything is as safe as possible. The doctors will take care of that, but you can also make sure that the hospital you choose is fully equipped and that your doctors are well familiar with your case.
It’s better to start labour naturally – if it doesn’t seem to start and you’re already overdue, doctors are likely to recommend a caesarean section before induction: Induction drugs provoke stronger contractions, which could increase the risks of the VBAC.
If everything goes as planned and you start labour naturally, the VBAC will be like any other vaginal birth. Just save your strength and follow the instructions of your midwife and your doctor, and soon you’ll be a mummy again!
Which are the possible complications of a VBAC?
The main complications would be the vaginal birth not being successful, which would require for you to undergo an emergency C-section, which has higher chances of being more complicated. However, that is a possibility that your doctors will have considered.
If you’re planning to have a vaginal birth after C-section or VBAC, you’ve already started your preparation by reading this article. Don’t forget that you may still need another C-section if something goes wrong, so be prepared for that as well. And remember that, if the birth of your baby isn’t like you dreamt of, the most important thing is to end up having your healthy munchkin between your arms!