If someone has delivered a baby through C-section and they are pregnant again, they might have the chance to choose between scheduling a repeat C-section or vaginal birth after C-section VBAC, and this procedure is not for everyone. If someone is thinking about the VBAC procedure, consult with a healthcare provider who can give us a better understanding of the procedure. Onlymyhealth got in touch with Dr. Archana Dubey, Consultant Gynecologist, Infertility and Laparoscopy, Motherhood Hospitals, Indore to know why mothers should avoid repeat c-section and instead opt for vaginal birth.
Why VBAC is a safer option than a repeat C-section?
A vaginal delivery, as opposed to another C-section, involves no surgery, none of the potential complications of the surgery, shorter hospital stays, and a quicker return to normal daily activities. VBAC may also be appealing if the pregnant mother wants to have a vaginal birth.
It's also important to think about future pregnancies. In case a couple would like to go for more than 2 kids, vaginal birth after cesarean would be a good option and one can sail through without having to undergo the risks of multiple caesarean deliveries, such as fetal problems.
The woman can be a good fit for VBAC if she is:
- Pregnant with one child or has a history of one or two low transverse C-sections, and had no problems that would avoid VBAC
- Pregnant with one child and have a history of prior C-section with uterine incision and have no problems that would avoid VBAC- unless it’s suspected that they had a prior high vertical (classical uterine incision.
- Woman who is pregnant with twins and has a history of 1 previous C-section, and otherwise a woman who underwent twin vaginal delivery.
VBAC is not for those women who have the following condition that would complicate vaginal delivery-
- Uterine rupture
- Uterine surgery like fibroid removal
- Prior vertical uterine incision
Factors that lessen the chances of VBAC include:
- Previous delivery within 18 months
- History of 2 or more prior C-sections and no vaginal deliveries
- A need for labour induction when starting with a closed cervix
- Advanced maternal age
- Stalled labour
- Excessive weight gain during pregnancy
- Preeclampsia
- Pregnancy that continues past 40 weeks
- Body mass index of 40 or higher
Also Read: Normal Delivery Vs Cesarean: Check Out The Pros And Cons
How does VBAC labour and delivery differ from routine vaginal birth labour and delivery?
If a pregnant mother chooses VBAC when they go into labour through the same steps as with any other vaginal delivery. However, the doctor will most likely advise keeping an eye on the baby's heart rate and being prepared to perform another C-section if necessary.
How to prepare for vaginal birth after c-section?
If someone has had a C-section and they have conceived again they might initiate conversing regarding VBAC at the first prenatal visit and discuss the concerns and expectations with the gynecologist also they need to give a complete medical record of the pregnant mother including previous C-section or any other uterine procedures. The gynecologist will be using the woman’s medical history to gauge the likelihood that she will have a successful VBAC.
Also, the woman can plan to have her baby at a facility that’s equipped to handle an emergency C-section. She should continue discussing the risks and benefits of VBAC throughout pregnancy, especially if certain risk factors arise.
Also Read: Here Are 5 Myths About Cesarean Delivery
What are the dangers of VBAC?
While a successful VBAC is linked to lesser complications than an elective repeat C-section, a failed trial of labour after a C-section is associated with more complications, including uterine rupture.
Uterine rupture is uncommon, occurring in less than 1% of women who attempt a trial of labour after a caesarean section. However, uterine rupture can be fatal to both the mother and the baby. The caesarean scar on the uterus ruptures during a uterine rupture. To avoid potentially fatal complications, an emergency C-section is required. The uterus may be surgically removed as part of the treatment (hysterectomy). The mother will be unable to conceive again if their uterus is removed.
What other advice do they have for women thinking about having a vaginal birth?
If someone is thinking about having a vaginal birth, talk to the doctor about it early in the pregnancy. Share the concerns and expectations with them. Ensure that they have a full medical history, as well as any previous C-sections and other uterine procedures. The doctor may calculate the chances of a successful VBAC.
Also, decide to have the baby delivered at a facility that is capable of performing an emergency C-section. Discuss the advantages and disadvantages of VBAC throughout the pregnancy, particularly if certain risk factors arise.
Image credits- freepik