VBAC - Vaginal Birth after Caesarean

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If your first pregnancy and labour ended with a c-section, it doesn’t necessarily mean your second has to. In fact, approximately 60% of mums can go on to have a successful VBAC (Vaginal Birth after Caesarean).

Whether or not this includes you will depend on the reasons for your previous c-section(s). If it was a first labour, it is often due to baby’s position or failure to progress (both very common in a first pregnancy), in which case there may be no reason for you not to attempt a VBAC if this is what you would like.

Who do I talk to about my options?

After a first caesarean, you are well within your rights to request an elective one again. Bear this in mind when you go to talk to your consultant prior to the birth. All women who have had a c-section previously are referred to a consultant to discuss options – normally at around 34 weeks. Arm yourself with plenty of information beforehand. Some consultants will have a strong view one way or the other with regards to VBAC. If your consultant doesn’t agree with your wishes, don’t just accept their decision; it’s your body, you should feel confident and entitled to discuss any reasons why they would refuse your request.

What are the pro’s and con’s regarding VBAC?

PRO’s

If successful, the recovery time is much shorter allowing you to get home more quickly to your existing child. You would be able to drive as soon as you felt up to it.
Lower risk of complications for both the mother and the baby.

CON’s

Very small risk of scar rupture. This is a VERY serious thing to consider, it is life threatening should it happen – but only occurs in approximately 1 in 1000 VBAC attempts.
Repeated C-Section can often mean much slower recovery time the next time around – so if you recovered very quickly the first time, it doesn’t mean you will again.

What if I choose to try VBAC?

If you wish to go ahead and try for this, your consultant may explain that you will be monitored constantly during labour. This may seem a little daunting as it gives the impression of being stuck to the bed but there ARE other options – speak to your consultant if you like to be mobile in labour there are many ways of monitoring the baby without your being tethered down.

Certain interventions are far less likely to happen if you have had a c-section previously. For example it is unlikely that you would be offered an induction using prostin gel or pessary as these is known to increase the risk of scar rupture. Sweeps and breaking your waters are still possible as is the syntocin drip – when carefully monitored and normally only in situations where you aren’t contracting at all and are overdue. You are unlikely to be allowed to go as far overdue when attempting a VBAC – the common practice seems to be you will be seen at the hospital at about 7 days overdue to decide the course of action.

What if I would prefer to have an elective Caesarean?

If you decide this is the way you would like to go forward - don't let your consultant tell you no! You are well within your rights to do this, just make sure you are armed with reasons why so you can argue your case should it be needed!

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