Vaginal birth after cesarean delivery
What is VBAC?
If you have had a previous cesarean delivery, you have two choices about how to give birth again:
You can have a scheduled cesarean delivery.
or
You can give birth vaginally. This is called a VBAC.
Patients opting for VBAC undergo a trial of labour (TOL) or a trial of labour after cesarean section (TOLAC).
When can one plan VBAC?
You can wait for spontaneous labour pain till 39 weeks of pregnancy after discussion with your gynaecologist.
If not, you can undergo VBAC as a planned procedure or due to precipitant labor.
How frequently is it done?
Healthcare professionals began to question the dictum, “once a cesarean, always a cesarean,” and subsequently, the number of patients undergoing VBAC delivery began to increase.
Many women express a desire to experience vaginal birth, and when successful, VBAC allows this to happen.
VBAC helps you avoid certain issues linked to multiple cesarean deliveries. including bowel or bladder injury, and problems with the placenta in future pregnancies.
Who can opt for VBAC?
You can opt for VBAC if
- You had a cesarean section at least 3 years ago
- You had a non-recurrent indication in previous cesarean
- You had previous vaginal deliveries apart from the cesarean section
- You have no medical complications in the present pregnancy
Who cannot undergo VBAC?
You cannot opt for VBAC if
- You had a previous classical cesarean section
- You had a ‘T’ or ‘J’ type incision or prior transmyometrial incision to resect fibroid/to facilitate open fetal surgery
- You had more than 2 prior cesarean sections
- You have a prior history of uterine rupture
What are the complications?
High risk of uterine rupture (0.7% to 1.5 % depending on the number of previous cesareans)
What are the factors to have in mind when you plan VBAC /TOLAC?
Facilities or hospitals offering TOLAC should have the capability to perform an emergency cesarean delivery.
Can I opt for painless labour during VBAC?
Definitely. Epidural analgesia or painless labour can be combined with VBAC and TOLAC.
Treatment and management:
Discuss with your gynaecologist:
- How to prepare your mind and body for VBAC
- How you can increase the chances of successful VBAC
Visit your place of delivery prior to 37 weeks and get acquainted with it and how to handle any emergency.
