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What to Know If You Want a Vaginal Birth after Cesarean

 

A vaginal birth after cesarean, often called a VBAC, is a procedure that many women opt for in order to reduce their recovery period and to avoid the possible complications that come with a cesarean. When attempting this kind of birth, there are many factors to consider. Keeping yourself informed about the many issues surrounding these births is key.

Uterine Rupture

A rupture of the uterus is a major concern of many healthcare providers when faced with a patient who has had a cesarean. The risk, however, is minimal. Women who attempt a VBAC have less than a 1 percent chance of actually having a rupture during labor or delivery. The minimal risk is considered by many to be less of a risk than the invasive procedure posed by a cesarean. Though the worst case when a rupture occurs is death of the mother and/or the baby, death is a rare occurrence during a rupture. A rupture may have few actual medical consequences, or it may result in the loss of the woman's uterus. 

If you want to attempt a VBAC, you should understand the risk of both a uterine rupture and the risk of having another cesarean. Both come with medical risks that should be weighed carefully. 

Pain Control

Part of the planning that goes into having a VBAC is often the type of pain control that the mother wants during the birth. The use of an epidural for pain control is strongly linked to an increase in c-section rates, making many VBAC patients wary about having them at all. To give yourself the best chance, you will likely need to come up with alternatives such as IV pain relief or a natural birth that uses the Bradley Method or Lamaze to control pain. 

Practitioner Choices May Be Limited

When your birth goal is to have a VBAC, the number of health practitioners that will work with you may be greatly reduced. In many states, it is illegal for a midwife to attend an attempted VBAC. It may also be illegal to have your birth at home. In addition, there are many doctors who won't shoulder any additional potential liability and will not attend these births. You may have to change hospitals or even drive outside of your own city to have the birth you want if the local hospital won't agree to allow you to try for a VBAC.

Unless you know that your current doctor will work with you to achieve a VBAC, you may have to spend time interviewing doctors before finding one who will commit to your birth plan. There will be some who simply refuse to agree to this type of birth. To ensure that your provider is on board with your plan, consider typing up a birth plan that describes the kind of birth you want to have. Have your caregiver read and sign the plan so that there won't be any confusion later when it's too late to change the way things are progressing.

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