VBACs explained

There are many reasons why a woman might want a vaginal birth when she had her last baby, or babies, by caesarian section. She might have had an emergency caesar, and now wants to try for a natural birth. Her planned c-section may not have been what she was led to believe, and now wants to try a different way. Or she may want to get back on her feet faster after birth, particularly if she has other children to look after. 

You might come up against some resistance from doctors or midwives as to whether they believe a VBAC is suitable for you.

 

There's a very small chance of uterine rupture, which means the re-opening of your old c-section wound.

 

Some hospitals have very specific procedures for a VBAC, such as setting a time limit on active pushing and sometimes with assisted vaginal births taking place in the operating theatre. If you want to know your hospital policy, check with doctors and midwives beforehand.

 

You can plan ahead for a c-section birth - from organising your partner's time off work, to stocking your freezer and planning care for another child.

 

VBACs have been deemed risky by some health professionals, mainly due to the fact there is a small chance of it resulting in uterine rupture. Attitudes have changed in recent times, and now it's possible to try for a vaginal birth after having two c-sections, which is known as a VBA2C, or to deliver twins vaginally after one c-section.

 

Studies show that between 50 and 80% of women who try for a VBAC are successful, according to a National Institutes of Health study in 2010.

 

An Australian study (Dekker et al. 2010) found that the risk of uterine rupture during VBAC was 0.15% in spontaneous labour, 1.91% in augmented labour and 0.88% in induced labour.

 

This results in an average of 0.5% of VBAC births ending in a uterine rupture.

 

94% of babies survive a birth that results in uterine rupture.

 

Talk to your doctor and midwives and find out why your first birth ended in a c-section. If the reason was a one-off situation such as a breech birth, that may not happen next time, you may be well placed for a VBAC.

 

The angle of your scar may affect your chances of having a VBAC. An incision at the lower part of your uterus may mean a VBAC is safer than when the scar is across the middle of your uterus.

 

When you're in labour, try and stay at home in a relaxed environment for as long as possible, and try and keep mobile.

 

If you decide a VBAC is for you, don't put yourself under pressure. You can tell friends and family that you'll "decide during labour" if that makes you feel more relaxed as your due date approaches.

 

There are lots of positive VBAC forums and midwives' blogs online, which are useful if you want to get a rounded view of the subject.