Vaginal Birth After Caesarian Section (VBAC)
Women who have had a caesarean delivery previously, and a baby vaginally in a subsequent pregnancy.
The Women’s Health Group will counsel and support you through your decision and give you all the advice you require.
Successful VBACs have lower complication rates than planned repeat caesareans which have lower complication. Research shows that VBAC is safe for the majority of women and that repeat caesarean may offer no advantages for the mother or her baby. However, mothers are not always aware of these facts and maternal request is one of the most common.
- There are fewer side effects with VBAC compared to planned caesarean section (increased pain, infection, reduced mobility, anaesthetic complications and blood clots).
- Women who have had a previous caesarean for breech are more likely to achieve VBAC.
- Women who have delivery vaginally before, especially if this was following a previous caesarean, are more likely to achieve VBAC.
- You can use other forms of pain relief, including epidural during your labour.
- Uterine Rupture risk drops significantly after first VBAC
- Scar weakness and tearing. You are more likely to have a repeat caesarean for an unrelated complication.
- Women over 35
- Overweight women (High BMI)
- Women who are diabetic and women who have pre existing medical conditions
- If you are pregnant with multiple births.
- Risks of c-section include, hysterectomy, blood transfusion, and ICU admission
Can labour be induced?
Yes, but we have to be cautious, Induction puts greater stresses on the scar on the womb (uterus). If the neck of the womb (cervix) is starting to open, breaking your waters is preferred as it is safer. If not, gel (Prostin) can be used very carefully but there is a 1 in 30 (3%) risk of the scar giving way with the gel. Your consultant will make the decision whether or not to use Prostin and will discuss it with you. Many women deliver successfully with Prostin but we induce labour on the Delivery Suite and watch you and your baby much more closely to ensure your safety. However the chance of delivering normally is if you go into labour yourself.
Does VBAC always work?
No, there is never a guarantee but we carefully monitor labour and ensure that you and your baby are given a safe labour. Occasionally, the baby becomes distressed or labour stops and we have to consider performing a caesarean section. This happens in a minority of cases.Successful VBACs are safer than planned C-sections -no surgery, lower risk of infection, no serious blood loss or complications from anaesthesia). If VBAC fails, however, you will undergo an unplanned section, but this carries its own risks. A caesarean section is a major operation and the consultant will be reluctant to put you or your baby at risk without a good psychological or medical indication.