VBAC stands for “vaginal birth after a C-section.” It occurs when a mother has another child after their previous pregnancy resulted in a caesarean section to facilitate the birth. This medical option is a possibility for many women, but there are several factors that you will want to discuss with your doctor to decide if this option is the right birthing plan for you.
The safety of the baby and the mother are the most important considerations to look at when considering the pros and cons of a VBAC. This process is not always safe for some women. If you try to have a vaginal birth, but you are at a higher risk of complications, then there could be some serious issues for you and your baby that could even be life-threatening. That is why you should speak with your OB/GYN and primary caregiver about the potential risks involved.
For VBAC to be considered as an option, both the mother and the baby must be in good health. Some doctors may even say that this option is possible if you are pregnant with twins after a cesarean section, assuming that everyone is healthy enough to go through the process.
There are also times when this option may be too risky. These are the critical points to review before discussing your desires with your primary care provider.
List of the Pros of VBAC
1. It eliminates the need to have a second surgery.
Although there are complications to consider with a vaginal birth, when a VBAC is possible, then the birthing process involves no surgery. That means there are none of the possible complications of a C-section to manage afterward. You will have a shorter hospital stay with this option, which means there is also a faster return to your regular daily activities. For some women it is an appealing option when they want to experience this form of childbirth.
2. VBAC can help you to avoid problems in future pregnancies.
When you and your doctor began to discuss the pros and cons of VBAC, then you are considering any future pregnancies that you may want to have as well. This process can help you to avoid the possible risks that occur when multiple cesarean deliveries happen, including placental problems. Every birthing plan that you can have which includes a vaginal birth after a C-section will give you another option in a future pregnancy to accomplish the same thing.
3. There are fewer risks associated with VBAC.
VBAC is associated with fewer overall complications for women when compared to elective repetitive C-sections. A failed trial of labor after cesarean section is associated with more complications, which includes a rare uterine rupture. That is why your doctor will be heavily involved in the decision to pursue this option with your pregnancy because a ruptured uterus will likely cause its removal, which means you would no longer be able to get pregnant in the future.
4. It is the safest route to take for the mother and the baby.
The bottom line from a medical perspective with a VBAC is that a successful vaginal birth is the safest option to take whenever it is a possibility. Most women who attempt this process with their doctor’s permission are successful with it. There is currently a 75% completion rate for expecting mothers who take this option after having a C-section during their previous experience. When you add in the other benefits, like being able to hold the baby for nursing, then it is easy to understand what it is such an advantage.
5. There are fewer risks of an infection with VBAC.
Every woman who faces the prospect of a caesarian section faces the chance that their incision could become infected, which incurs and up to 6% of the procedures which are performed each year. In addition to eliminating this risk, there are fewer issues with blood loss, deep vein thrombosis, and zero complications related to the administration of anesthesia. You will also find that it is much less likely for the tissues of the uterine lining to become infecting during a vaginal birth when compared to a C-section.
6. Babies experience health benefits thanks to VBAC.
The advantages of a successful VBAC for the newborn are numerous if it can be a successful experience for everyone. There is a lower likelihood that the infant will experience breathing problems with this option. Even when they do happen, they are usually temporary and only require a short stay in the facility’s NICU. The child will face lower risks of experiencing immune-related problems, such as asthma or allergies. There may be health benefits later on in life that include a lower risk of diabetes development as well.
7. There are fewer opportunities to suffer an injury during the birthing process.
If your doctor authorizes a VBAC, then you are less likely to suffer an injury to your bowels or your bladder because there is no abdominal incision to make. Some mothers may need to have an episiotomy to accommodate the size of the head for the baby because the vagina is unable to stretch enough to allow the birth to occur. This slit in the perineum prevents a natural tear and accommodates moments when the shoulder of the baby gets stuck behind the pelvic bone. Some providers may want to perform this procedure if the newborn as an abnormal heart rate or forceps are necessary for an operative vaginal delivery.
8. You will not need to support your stomach as much during your recovery.
When you have a C-section, then you are having a major surgery. You will be restricted from lifting anything heavier than your baby for 2-4 weeks – and sometimes longer, depending on your circumstances. You’ll be asked to support your stomach in the weeks after the procedure as well, which means holding your belly when you cough, sneeze, or laugh because the movement could disrupt the sutures.
9. Your body may make milk faster than it would with a C-section.
Most mothers will begin to make milk after they give birth, whether it is through a VBAC or a C-section. You will be able to start nursing right away in most situations if that is your desire. If you choose to have a vaginal birth with your doctor’s consent, then your body will make the milk a little faster than it would if you had to endure a surgery to finalize the delivery.
List of the Cons of VBAC
1. There are specific risk factors that limit who is eligible for a VBAC.
There are five specific key points that your doctor will want to review with you if you are thinking about a VBAC for a current pregnancy. Women who have a body mass index of 30 or higher are typically advised to avoid having a vaginal birth after they received a C-section before. Additional factors include high blood pressure during the pregnancy (pre-eclampsia), age (older than 35), a large fetus, or if the cesarean occurred within the last 19 months.
2. Some women will not qualify for a VBAC because of their C-section.
You and your doctor will need to discuss how your previous cesarean section was completed when you had your last child. The type of scar that you have on your uterus from your C-section will determine if you are eligible for this procedure. If your scar is vertical, then you cannot attempt a VBAC because of the risk that the scar could burst or tear during the birthing process. Only when the scar is low and transverse will a VBAC be considered, and even then, it is only if your other risk factors are in an acceptable range.
The scar that is on your abdomen does not always reflect the positioning of the scar on the uterus.
3. You cannot have a home delivery if you opt for a VBAC.
Once you have had a caesarian section as part of the birthing process, then you are no longer eligible from a medical perspective to have a home birthing plan. With a VBAC, your doctor will want you to go into labor at a facility which can perform an emergency C-section. That way, you will have a secondary option that can save your life and the life of your baby should something unexpected occur. You may also notice additional changes from previous experiences, such as your healthcare provider wanting a continuous monitoring of the baby’s heart rate while being prepared for the surgery if needed.
4. Your contractions could cause the scar to tear.
In a small number of instances, the contractions that occur during the birthing process can cause the uterus to tear. After a caesarian section, it usually happens along the scar, but it may also occur in other locations. This outcome will result in an emergency C-section, which carries a slightly higher risk for a negative result when compared to the scheduled type. The odds of this happening when a VBAC is authorized by a doctor is roughly 1 in 200 cases. Even if the rupture occurs in a facility equipped to manage this issue, there is up to a 10% risk that something adverse could happen to the baby.
5. Women may not know what to expect with a VBAC after a C-section.
The birthing process can be an empowering moment for a woman. If your only experience with childbirth involves surgery, then you may not know what to expect with all of the contractions, pushing, and then the delivery of the placenta later on. That uncertainty can be enough for some expecting mothers to decide that an elective C-section is the better option because they are more confident about a repeat operation. You would also avoid the potential for long, grueling hours of labor that some women endure before ending up in surgery anyway because of a complication from the VBAC.
6. You will still face the risks of post-partum depression after coming home.
After you bring your baby home after a VBAC, you might find yourself going through a roller coaster of different emotions. You could feel anxious, worried, or tired beyond what you regularly experience for the first few weeks after giving birth. This set of feelings occurs because of the various hormone changes your body is experiencing. If you experience this disadvantage for more than a couple of weeks, then you will want to speak with your doctor to address the risks of post-partum depression. About 15% of new moms encounter this issue.
The pros and cons of VBAC are all dependent on the health of the expecting mother. If you have had previous vaginal deliveries in addition to your last C-section, then that increases the probability of a successful experience. Some healthcare providers won’t even offer this option if you’ve had more than two prior cesarean sections. Start having these conversations as early as you can with your medical provider as you establish your birthing plan to ensure that the birthing process fulfills your every expectation.