Vaginal birth after cesarean (VBAC): Is it right for you?
- Article reading time: 5 minutes
If you have previously given birth by cesarean section and are pregnant again, you may be wondering whether vaginal birth after cesarean (VBAC) is an option for you. While VBAC is possible for many women, there are several factors to consider when deciding whether this is the right choice for you and your baby.
Factors to consider when choosing vaginal birth after cesarean (VBAC)
The most important factor to keep in mind when considering vaginal birth after cesarean is the safety of you and your baby. Your doctor will help evaluate the following factors to determine whether vaginal birth after cesarean is a safe option for you.
Your health
For vaginal birth after cesarean (VBAC) to be considered, both you and your baby must be in good health. In some cases, even women carrying twins may attempt VBAC if the doctor determines that all are sufficiently healthy. However, certain health conditions can make VBAC very risky, including:
– Obesity (body mass index of 30 or higher)
– Preeclampsia (high blood pressure during pregnancy)
– Advanced maternal age (usually over 35 years)
– Previous cesarean within the past 19 months
– Very large baby
Your previous cesarean scar
The type of scar on your uterus from your previous cesarean is an important factor in determining whether vaginal birth after cesarean (VBAC) is safe for you. Two types of incisions are made during a cesarean:
– Vertical incision (from top to bottom)
– Transverse incision (from side to side)
If you have a vertical cesarean scar, VBAC is generally not recommended due to the high risk of uterine rupture during labor. However, if you have a low transverse scar and other risk factors are minimal, your doctor may allow you to attempt VBAC.
Hospital readiness
Not all hospitals are equipped to perform vaginal birth after cesarean (VBAC). Although the risk of uterine rupture is low, the hospital must be prepared to handle this emergency if it occurs. Consult your doctor in advance to ensure that the hospital you plan to use offers the option of VBAC.
Benefits of a successful vaginal birth after cesarean (VBAC)
If vaginal birth after cesarean (VBAC) is an option for you and you are interested in a natural delivery, there are several potential benefits to consider. Approximately 70% of women who attempt VBAC are successful. Compared to a repeat cesarean, a successful VBAC offers:
– No need for surgery
– Less blood loss
– Faster recovery
– Lower risk of infection
– Reduced risk of injury to the bladder or intestines
– Fewer complications in future deliveries
It is important to note that even with a low transverse scar and good overall health, there remains a small risk (less than 1%) of uterine rupture during VBAC. Although rare, this complication can be very dangerous for both mother and baby. Before making your decision, be sure to discuss the risks and benefits thoroughly with your doctor.
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