Sure, VBAC sounds like a scary medical term, but if you’re pregnant with your second (or third or fourth …) baby after a previous cesarean delivery (aka c-section), you might wonder if you could have a vaginal delivery next time. A vaginal birth after cesarean delivery (VBAC) is safe and healthy for the vast majority of women.
So, if you’re thinking of VBACing, you’ll be glad to know the choice to do it can potentially help you avoid the risks of having multiple surgeries. But this isn’t one of those coin-flip choices you can make at the instant you find out you’re expecting and cross your fingers. Quite a few factors are involved with success, and things can change as pregnancy progresses – a few of these important considerations are outlined below.
So, What Exactly is VBAC?
So you’ve had a c-section in the past. What are your options for the next time? You may opt for another c-section, which can often be planned ahead of time. Another option might be a vaginal delivery, or VBAC – vaginal birth after cesarean. Let’s unpack what VBAC is, the pros and cons of VBAC, and what a trial of labor after cesarean (TOLAC) entails.
Vaginal birth after cesarean, or VBAC, is the delivery of a baby vaginally in a woman who has had a previous cesarean delivery (C-section). Trial of labor after cesarean, or TOLAC, is the process of trying for a vaginal birth after the previous cesarean delivery.
VBAC is a safe and appropriate choice in many women with a previous cesarean (including up to two previous cesareans), and is even recommended in many cases by the American College of Obstetricians and Gynecologists (ACOG). But, like any medical decision, not everyone is a good candidate, and the choice should be made on a case-by-case basis with a trained health care provider.
Should You Go for VBAC or Another C-Section?
This is just one of many questions that expectant mothers must grapple with – like so many things during pregnancy – nearly everything depends on a multitude of factors and can change at any time. VBAC can be safe and rewarding for many women, giving you things like shorter recovery time than a C-section, and fewer complications than having multiple C-sections.
Still, going for a VBAC depends on things like the type or incision you had in the last C-section, the total number of C-sections you’ve had in the past, and you have to factor in any other health conditions or pregnancy complications that might stand in the way. While there’s no certain number of C-sections that’s considered ‘safe’ for each person, and every individual body is different, the Mayo Clinic says that TOLAC isn’t recommended if you’ve already had three or more prior C-sections.
So, have this conversation with your medical practitioner early in your pregnancy, they can help you think through all the factors and circumstances that could be involved in your case and that can help you weigh the risk/benefits of each option. And know that continuous monitoring is usually required, to make sure VBAC goes as smoothly as everyone wants it to, especially considering that there is a slightly increased risk of uterine rupture. So, you’ll definitely want to be delivering somewhere that supports this sort of monitoring.
What Are the Perks of a VBAC?
There are some special advantages of a VBAC attempt. One of the most important benefits of VBAC vs repeat cesareans is that it comes with a much lower risk of complications – infection, bleeding and injury to other organs. VBAC also tends to mean shorter hospital stays, and more rapid recoveries, which is a big plus for most moms and their families.
If that is what you’re looking for, VBAC can also provide a more satisfying birth experience for some women by allowing for a more natural birthing process. Some women feel this can also promote bonding between mother and baby.
But, Are There Any Risks of a VBAC?
The vast majority of VBAC attempts are uncomplicated – some 70 per cent result in a successful vaginal birth – And, there are some risks to know about. The most serious risk is uterine rupture, which can occurs when the scar from a previous cesarean tears during labor. True rupture can be life-threatening for both mother and infant.
Things that can make a successful VBAC less likely include your labor taking longer than usual, a previous failed TOLAC, or a need for emergency cesarean. Other things that can up your risk are things like a high body mass index, less than 19 months since your last C-section, gestational diabetes, a large baby, and preeclampsia.
Am I Eligible for VBAC?
Consider keeping an open mind whether or not you choose to pursue a VBAC, but if you’re eligible be sure to find out about your options. A VBAC might not be a possibility if you’ve had three or more c-sections in the past, or if you have certain medical conditions or a uterine classical incision for a previous c-section (you might not be eligible if any of these things are your past medical history). Your past medical history and the reason for your prior cesarean section can also affect your eligibility and safety of a VBAC. Be sure to always be open with your medical provider about any issues you have had.
Getting Ready for VBAC
Preparation for a VBAC is something you start long before your due date: counseling (and your own research) about the risks and benefits will be crucial, and it’s likely that you’ll be encouraged to enroll in childbirth education classes geared towards VBAC.
You may also have to make certain lifestyle changes to improve your chances of a successful VBAC, such as maintaining an ideal body mass index, properly managing any chronic medical ailments like diabetes, and avoiding certain medications or procedures that could complicate delivery.
A birth plan can also be helpful. It can give you time and documentation to specify your views on things such as pain relief, labor positions and special requests. Talk it over with your provider to make sure you’ll be safely accommodated.
Summing it Up on VBAC
Ultimately, whether or not a VBAC is better than C‑section or vice versa is a decision you have to make for yourself in conjunction with your doctor. So, if this is an option that your doctor thinks is a viable solution for you, have a conversation with them at the beginning of your pregnancy. Please know that when you reach a decision, it is important to understand that you are not done having this conversation. In fact, this conversation will be ongoing throughout your pregancy. Consider keeping an open mind as you progress in your pregnancy up until and even after your delivery. We wish you the best of luck as you navigate this amazing time in your life!