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What is a VBAC and how do I know if I can have one after my c-section?

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Kiindred

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Created on Oct 30, 2023 · 6 mins read
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Headed for the labour room again but hoping for a vaginal delivery instead of a c-section? You must have a ton of questions – I know I did!  And oh man, did I fire them at my poor, unsuspecting Doc every chance I got! Luckily, I landed with a gem who patiently answered each and every one of them. I also had a lot of questions about what to expect in the coming days. If you ask me, Google is a blessing for mums and a huge relief for gynaecologists who get stuck with us! For one, we point all our simple questions at Google instead of her: like, “Why is a VBAC called a VBAC?” And “how much pain should I expect?” “And, what the heck is a lotus baby”? Eventually, I got answers to my basic questions by doing a quick search. This helped me be informed enough on the subject to ask her the right questions, like, “What is my risk for a vaginal delivery after my last c-section?’ Here’s how you can do the same:


Understanding VBAC


Giving birth is a life-changing experience that is unique to every woman and being wheeled to the delivery room for a c-section is quite different from walking in for a VBAC.

For some women, their first birth may have been a caesarean section. This could be due to medical reasons or a personal choice. When their second time rolls around, some women get the opportunity to have a vaginal birth, also known as a VBAC. (Vaginal birth after cesarean, hence VBAC.)

VBAC basically refers to giving birth vaginally after a previous caesarean delivery and, typically, is the preferred route. In the year 2020 alone, around 63% of the total childbirths in Australia were vaginal deliveries. It also has a faster recovery time, which is a huge plus because that baby will keep you up and on your toes.

Once I knew what a VBAC was, I wanted to know if it was worth trying for one. After all, it would be awful to endure hours of agonising labour pains only to be forced to have a c-section in the end.

Here’s what I learned: The success rate of VBAC depends on various factors. Things like the reason for the previous c-section, the type of uterine incision, and health and risk factors influenced the success of a VBAC. As I learned, this was the right question to ask my doctor because only a healthcare professional who knows your body can guide you best.


The risk of having a vaginal birth after c-section


While a VBAC is a safe option for some women, it does not come without risks. It’s important to remember that a c-section is a major surgery and that healing from a c-section requires time. Trying for a VBAC comes with its fair share of risks, the primary being the possibility of uterine rupture. A uterine rupture can be life-threatening for both the mother and the baby, and it isn’t worth the risk of trying for a vaginal delivery. The risk is higher for women who have had a caesarean delivery or a  transmyometrial surgical incision.

Other potential risks include infection, bleeding, and the need for an emergency caesarean delivery. Again, the risks differ from case to case, and your doctor will be better able to evaluate these probabilities and weigh the pros and cons of a VBAC.

Our advice: discuss the risks and benefits of VBAC with your healthcare providers and make informed decisions based on your body, and your circumstances.


What increases your chance of a VBAC after delivery?


Labour pains are unpleasant,(and that’s putting it mildly), so it’s natural to wonder if the discomfort is worth attempting a VBAC. Being sent for an emergency c-section after hours of labour isn’t part of the ideal birth plan. But then again, birth plans hardly seem to go as planned.

There are several factors that increase a woman’s chance of having a successful vaginal birth after a previous c-section. Previous vaginal deliveries can lead to higher chances of successful VBAC. Even if you’ve never had a vaginal birth before, you can choose VBAC if you go into labour naturally without being induced. Moreover, a c-section incision made horizontally across the lower part of the uterus may increase the chances of a successful VBAC. That is also less likely to cause a uterine rupture.

However, not everything can be controlled when it comes to childbirth so there is still a bit of risk involved. Every organ needs to be in optimal health and “placement” to give VBAC a try; and yes, your cervix has a say too and is one of those organs!

A cervix that is already dilated, effaced, or soft can make it easier for the baby to descend and for labour to progress, improving the likelihood of a successful VBAC.

If you are in good health, and have no underlying medical conditions you just might be luckier than a mum who isn’t in the optimal weight or bp range.

Similarly, spacing out pregnancies and following a minimum time gap like 18-24 months between each pregnancy also helps, giving the body enough time to heal.

FAQS:


Still got questions? We understand. Here’s the part where we help you understand why a VBAC isn’t the same as a vaginal birth and what the deal is behind a lotus baby. (Nope, it has nothing to do with how it looks.)

What are the four types of childbirth?


The four types of childbirth are natural childbirth, medicated childbirth, caesarean childbirth, and induced childbirth. Natural childbirth is a non-medicated vaginal delivery with minimal intervention. On the other hand, medicated childbirth uses pain-relieving drugs such as epidurals, narcotics, or nitrous oxide. Induced childbirth, while still natural and vaginal, uses medications to stimulate contractions and start labor.

Then there is the c-section, that you’ve probably been through. It is a surgical procedure where the baby is delivered through an incision in the mother’s abdomen and uterus.

Is vaginal birth painful?


Vaginal birth can be a painful experience for some women due to the intense pressure and stretching of the vaginal and perineal tissues. However, several pain relief options are available during labour, including breathing techniques, massage, hot and cold therapy, and medications like epidurals or narcotics.

But yes, a vaginal birth is painful – there’s no two ways about it.

How can I give birth without pain?


I have a really low pain threshold, and my husband and I often joke that perhaps labour pains are one of nature’s best plans for natural birth control! I mean, babies are adorable, but the idea of pushing them out and the trauma of birth are enough to make you think twice before having another one.

Unfortunately, there’s no guaranteed way to give birth without pain!

Fortunately, thanks to some genius scientists, we have figured out ways to manage the pain.

Pain management options include epidurals and breathing techniques that can help women through labour and delivery. However, there is no guarantee that it will work  since medications act differently on different people, and not everybody has the same pain threshold.

What is a lotus baby?


A lotus baby is a newborn who experiences a lotus birth and remains attached to the placenta until it naturally separates.

Asking your doctor the right questions:


It is important to keep in mind that only your doctor can assess the risks and benefits of trying for a VBAC and help you make the best choice for you and your baby. If you are hoping to deliver your baby vaginally this time around, make your wishes known to your ob/gyn and they can work with you according to your medical history to help you achieve the birth plan you desire.


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