Vaginal Birth After Cesarean

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VBAC stands for vaginal birth after a cesarean. Which essentially means, that women who have had a C-section for a previous delivery can opt for a vaginal delivery for subsequent deliveries. Earlier, it was taken for granted that anyone who’s had a c-section earlier will always a c-section for all subsequent pregnancies. However, advances in fetal medicine and obstetric methods have now made it possible for a normal vaginal birth even if you have had to opt for a cesarean section in the past.

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Despite the possible chances of VBAC, certain risks are inherent, and it is important to be cognizant of the same. Age is a critical factor – the older you are the less likely you are to be able to deliver by conventional methods following a C-section delivery. Obesity or higher body mass index is also a limiting factor as is the higher birth weight of the to-be delivered baby. Also, if you have had a longer (over 40-week) pregnancy you are much less likely to have a vaginal birth; and similarly, if you have had less than 18-month gap between the two pregnancies even that could be an impending factor.

There is so a real risk of serious complications for the child leading to long-term neurological damage or even fatality. All these risks are further escalated if there has been a case of an unsuccessful VBAC in the past.

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The key to a successful VBAC is a continuous conversation with your gynecologist and regular electronic fetal monitoring. Having an open mind is essential and allowing the gynecologist to take the most informed decision is critical. It is important to note that a safe childbirth and the safety of both mother & child are of paramount consideration. If your gynecologist, believes that there is any additional risk involved, it may be better to opt for a safer delivery option rather than a preferred one.

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Not all women are candidates for VBAC and likewise not all challenging cases can be out rightly ruled out. The reasons for a previous C-section play a vital role in determining the current possibility of vaginal birth. The first pointer would be if the previous C-section was a low-transverse uterine incision. If this criterion is met, then there is a good chance a second pregnancy can culminate in natural birth.

Also, important is that one shouldn’t have had any other or major uterine surgery or suffered a uterine rupture. The gynecologist would also be required to ascertain if the pelvis is large enough to accommodate the passage of the baby while being sure that the mother is not suffering from any other medical or obstetric problem.

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