VBAC: vaginal birth after Caesarian – worth the risk?

It used to be “once a C-section, always a C-section,” but this way of thinking was challenged quite a while ago and is leading to many women have vaginal births after Caesarians, or VBACs.

Back in the day when C-sections were done only one way – a large incision right down the front, VBACs couldn’t have been attempted. The risk of rupturing the uterus during labor would have been way too high, but now with the better methods of C-sections, it’s not an impossibility for many women. Of course, in the event of life-threatening emergencies, such big incisions still could be done, but as a rule, they aren’t.

According to VBAC.com, “Current evidence shows that the majority of women can have safe vaginal births after a prior cesarean (a VBAC), but according to the US Centers for Disease Control the VBAC rate fell 67% in the last ten years.” If people wonder why that may be, I think it may be because of the fear of lawsuits. Doctors are being sued left, right, and center, for anything that may go wrong and – in their mind – a VBAC can go horribly wrong sometimes. But, it doesn’t have to!

There are many advantages to have a VBAC if it’s possible. Having a vaginal delivery keeps you from having another scar in your uterus; this is particularly important if you want to have more children. And, of course (usually) recovery from a vaginal birth is much easier than a C-section, especially if you already have a child at home.

According to physicians, a good candidate for VBAC is a woman who:

• Has had only 1 C-section and the incision is low and side to side
• Has had 2 C-sections before, but has successfully had a vaginal delivery
• Agrees to give birth in a hospital in case of emergency
• Does not have a medical reason (baby or mom) to have a C-section

While having a C-section should never, ever be considered as failing in your role as a mother, there are substantial benefits to delivering vaginally. The risk to you is also much lower if the delivery doesn’t require a C-section because sections are major surgery. Many people don’t see it as such because it’s so common, but a C-section is major abdominal surgery with all the associated risks.

If you want a VBAC, speak to your doctor or midwife about this. If you have a doula, she will need to be part of your plan as well; make sure that she is comfortable with this or you may need to find another doula.

Finally, if you do go for a VBAC and end up having a C-section, please don’t feel that it didn’t go “right.” We can’t plan the births, we can only make decisions and hope that they can go the way we want. The best plans are to know when to go with the flow and do what needs to be done – for your best interest and that of your baby.

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