Tundraco's Daily Living Guide to Pregnancy VBAC - Vaginial Birth After Cesarean

In the past, the rule was that once you had a cesarean section, all subsequent children also needed to be delivered by a c-section. This is no longer the case. Thanks to medical advances and new surgical techniques used during a c-section, most women are now able to deliver a child vaginally after having undergone a c-section with a previous pregnancy.

According to the American College of Obstetricians and Gynecologists, 90% of all women are good candidates for a vaginal birth after cesarean (VBAC). However, you must understand that even if all indications are that you will be able to deliver vaginally, it might simply be impossible. You must understand this risk and be prepared for a c-section if it becomes necessary.

• Find out why your previous c-section was done. In most cases the reasons behind the c-section was based on your condition and your pregnancy - at that point. Each pregnancy is different and the chances of the same set of circumstances occurring again are rare. Therefore, you should be able to deliver vaginally. If, however, you have a medical condition that makes a vaginal birth risky or impossible, you may not be a candidate for VBAC.
• In order to be a candidate for VBAC, it is preferable that the scar on your uterus, from the previous c-section, be a low, side-to-side (low transverse) scar, rather than up and down.
• If your uterine scar is vertical or if you have a high horizontal scar, the American College of Obstetricians and Gynecologists advises against trying for a vaginal birth. This is due to the increased risk of suffering an uterine rupture.
• The direction of the scar on you abdomen is not important, just the one on your uterus.

The best preparation that you can do when preparing to attempt a VBAC is to be in the best shape possible. This means eating well, exercising, and take a VBAC prenatal course.

• Make sure that your obstetrician is comfortable with a VBAC. You will tend to have a better outcome with a doctor that is a firm believer in VBAC.
• Learn meditation and breathing techniques to help you through the labor.
• A good mental attitude has almost as much to do with a good outcome as does your physical condition, so think positive thoughts!

After having undergone a c-section, it may not be possible for you to deliver vaginally. This possibility should not prevent you from trying. A trail labor is simply that – a trail to see if you can deliver the baby vaginally. In a trail labor, labor is allowed to progress naturally. If it works, and it does 82% of the time, the trail was successful.

• If complications arise or if the labor does not progress, you will have to give birth via a c-section.

• If attempting a vaginal delivery after having had two or more c-sections, the success rate drops to about 75%, lower but still worth well worth the effort of trying to deliver vaginally.

• There is an extremely slight risk that during a VBAC your uterine scar will rupture. In this case, an emergency c-section will be performed, the baby will be delivered and the rupture repaired.

A c-section is a major medical procedure, and it comes with some major medical risk. You are four times more likely to die from having a c-section than you are from delivering vaginally. With each subsequent c-section, your risks are increased.

• C-section's are, on occasion, necessary. They have saved the lives of many women and their babies, but they are not risk free.

A vaginal birth is much safer for both the mother and the baby, and should be attempted if it is medically sound to do so.

• There are fewer complications and a faster recovery from a vaginal birth.
• You are able to bond better, and quicker, with the baby.
• The baby suffers less stress and tends to suffer fewer complications.
• Many women report feeling a sense of loss after undergoing a c-section. They almost feel as if they failed because they did not deliver the child vaginally. Delivering vaginally with a subsequent child can help make them feel that they have accomplished what they have set out to do – by following all the 'normal' steps.