Categorized | Pregnancy Articles

VBAC – Vaginal Birth After Caesarean

What is VBAC?
Pronounced as ‘veeback’, VBAC is an abbreviation for vaginal birth after caesarean. This is used to describe the situation when a woman gives birth vaginally after having had at least one baby born by C-section. In this case you plan to get in to labour to produce the baby vaginally and go through what is called a “trial of labour.”

The main difference between a normal delivery and VBAC is the frequency and the detail to which your labour will be checked. The care provider will continuously offer electronic foetal monitoring that helps to know the baby’s heart rate and your contractions, these need to be measured all the time.

Women who have undergone only one cesarean delivery can consider VBAC as a safe option for their next delivery. The other cases when you can opt for a VBAC are –
•    If you have only one low, side-to-side scar from a C-section
•    In case you’ve undergone 2 caesareans before, but also had a vaginal delivery
•    The hospital you choose to deliver at has all the tools, equipment and a trained staff to handle the task and perform a quick C-section in case of any emergency

It is safe to plan a VBAC when you are older than 35, the fetus is large or if the pregnancy exceeds 40 weeks. However considering a VBAC is unsafe when you have two c-section scars and no vaginal delivery before. Also any scarring above the lower, thinner part of your uterus can make VBAC a dangerous option to opt for.

Advantages of VBAC –
Opting for a vaginal birth after caesarean has its own set of benefits when compared to another C-section –
•    A successful VBAC helps you sidestep a major abdominal surgery and the risks associated with it
•    You will avoid another scar on your uterus. This is important for women planning a future pregnancy.
•    Less risk of infection as compared to C-section
•    You have less pain after birth and spend fewer days in the hospital
•    Your baby experiences less trouble in breathing normally
•    You play a more active role during the delivery of your child

Disadvantages of VBAC –

The disadvantages that VBAC holds are similar to any vaginal delivery –

Short term effects –
•    Pain due to bruising and stitches in the area between your vagina and back passage
•    Urine leaks until the area round your vagina recovers

Long term –
•    Vaginal birth can increase the chances of the uterus slipping into your vagina (prolapse). However, there are a number of factors related to that other than vaginal birth like the kind of vaginal birth you had, the deliveries you’ve gone through, if you mother or sister suffered from prolapsed etc.

Also pregnancy can weaken your pelvic floor, which implies that you need to continue with pelvic floor exercises.

Risks included in VBAC –
The major risk associated with VBAC is Uterine Rupture. Although this risk has even less possibilities than 1% and has even remote chances of happening in case you had a “bikini-cut” c-section the first time.

The uterus rupture takes place around the site of your c-section incision and results in severe blood loss and oxygen deprivation for your baby. The risk of uterine rupture increases when labour needs to be induced or augmented. Experts are of the opinion that it is better to leave the attempt of a VBAC if oxytocin needs to be used to start the contractions and keep them going. You could land up with hours of labour pain and take recourse to a C-section. An unsuccessful VBAC that needs C-section to handle the situation after the labour pain begins carries more risk than a planned C-section. The surgical complications like excessive bleeding leading to blood transfusion or a hysterectomy and infections in the uterus and the incision are at risk of cropping up. These complications augment in case of an emergency caesarean.

Recovery from VBAC –
A recovery from VBAC is similar to your recovery from a vaginal birth. After a vaginal birth the mother and the child are discharged from the hospital within 24 to 48 hours. On the contrary, recovery from a C-section will take you anywhere from 2 to 4 days along with a long period of precautions to take especially with a few activities until the incision heals. The risk of catching an infection during both a vaginal and caesarean delivery is less, still you are provided with a list of infection signs you need to watch out for during the first few weeks post delivery.