Vaginal Birth After Caesarean Delivery (VBAC): Facts, Safety, And Risks

If you’ve had a caesarean delivery (c-section) in your previous pregnancy, you may be curious to know whether you will be able to deliver vaginally in your subsequent pregnancy. 

While it was once assumed that women who have had a c-section would deliver their next baby in the same manner, recent research indicates that vaginal birth after caesarean (VBAC) is possible and considered a safe option for many women. 

However, your healthcare provider may recommend VBAC only after carefully reviewing your medical history and overall health. Keep reading as we give you more details about VBAC, including the benefits and potential risks of this procedure.

Can You Have a Vaginal Birth After a C-section?

Yes, VBAC is possible if you meet the criteria of TOLAC or trial of labour after caesarean. A VBAC is considered safe as it helps prevent surgery and is a great delivery option if you want to have multiple kids. For instance, if you are pregnant with your second/third child now, and want more children down the line, then a VBAC might be wise because repeated C-sections are dangerous. Plus, if you have a successful VBAC now, your chance of another successful VBAC goes up too.

Who Is a Good Candidate for VBAC?

If you are considering VBAC, your healthcare provider will look at the following scenarios to determine whether you are a good candidate for this procedure.

• You are in good health: If you do not have any pregnancy complications and your baby’s size is normal, then a VBAC is a good possibility.
• You have delivered vaginally before: Research suggests that if you have already delivered a baby vaginally, even before your c-section, your chances of having a safe and successful VBAC rise to 86%.
• You had a low-transverse uterine incision: the kind of c-section incision you had matters too. A low transverse incision, also referred to as a bikini cut, is made low on your uterus and is the most common. This incision is also associated with a lower risk of uterine rupture in future births.
• Your labour begins spontaneously: Many labour-inducing medicines cannot be administered to women with uterine scars. This means that if your labour starts spontaneously and progresses well, only then a VBAC is recommended.

Who Should Avoid VBAC?

You are not considered a good candidate for VBAC if you have the following conditions in your medical history.

• Your c-section incision is low or high-vertical: These incisions are more likely to result in uterine ruptures than low-transverse uterine scars.
• You had a uterine surgery or uterine rupture: A prior uterine rupture in pregnancy is rare, but if it has happened, then a VBAC is a definite no-go.
• You have certain health complications: Certain health complications and conditions may make c-section a necessity. Moreover, if your baby has a heart condition or is lying sideways in the uterus, then your doctor might ask you to opt-out of VBAC.
• Your previous baby was born recently: If it has been less than 12 months since your last delivery, which is considered a short interpregnancy interval, a VBAC is not recommended.
• You are having triplets: A VBAC can still be considered with twins (with a proper low-transverse C-section), but this procedure may not be recommended if you are carrying triplets.

What are the Benefits of VBAC?

VBAC is often considered a safe delivery option for women who have had a prior c-section. It also offers the following benefits.

• No surgery: C-section involves a major abdominal incision, whereas VBAC requires no surgery, and is associated with less blood loss and a lower risk of blood clotting.
• Fewer complications: VBAC reduces the risk of complications, such as incision infections or injury to the surrounding organs while c-section surgery.
• Faster recovery: A c-section incision may take several weeks or even months to heal, but vaginal birth will allow you to leave the hospital soon and also be up on your feet sooner.
• Easier future pregnancies:  As mentioned, if you hope to have babies in the future, VBAC can help avoid the risk of multiple caesareans and complications like placenta previa. 

What are the Possible Risks of VBAC?

The biggest risk is an unsuccessful VBAC, where you may be forced to give birth via an emergency C-section. This scenario may occur due to various reasons, for instance, your labour doesn’t progress or there is evidence of fetal distress. 

Another cause of a failed VBAC is a uterine rupture, which is when the scar on your uterus from a previous C-section opens during labour, putting you and your baby at risk. Fortunately, this condition is extremely rare.

How to Prepare for a VBAC?

The first step for preparing for a VBAC is by speaking to your healthcare provider and discussing your medical history and candidacy. After reviewing your health records, your doctor can advise if it will be safe for you to have a VBAC or not. 

If you are a good candidate for VBAC and have a low-risk pregnancy, your preparation will be no different from getting ready for a vaginal birth. 

Conclusion

Most women can safely opt for vaginal birth after caesarean and have a successful delivery without any complications. If you want to opt for VBAC, speak candidly with your healthcare provider and determine whether this delivery method is suitable for you or not. 

If you are in good health and there is no fetal risk, your doctor will give you a go-ahead for VBAC, but if there is any complication, your provider might suggest you consider other birthing options.

Also read:

What to expect during vaginal birth: Tap this post to learn everything about vaginal birth and tips to prepare for labour and childbirth.

How to treat scars after a c-section delivery: We have gathered tips to help you care for your c-section scar after delivery and speed recovery.

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