Vaginal Birth After C Section: Benefits And Risks
Today, more women than ever before are having cesarean deliveries, sometimes or more often known as C-sections, which is a medical operation that involves making an incision in the belly and uterus to deliver a baby.
If you have previously had a cesarean delivery (C-section), it does not totally guarantee you will have to do it again; instead, you must determine whether to give birth vaginally or not. Many women who have previously had a C-section can surely have vaginal births or deliveries. They can have a vaginal birth after cesarean, known as planned Vaginal Birth After Caesarean (VBAC), or just opt for another c-section itself, known as Elective Repeat Caesarean Section (ERCS). There has not been a lot of data on the health risks and results related to VBAC to ERCS until recently.
Now, one of the most important factors you have to consider is your and your baby’s safety. It should be your first and foremost priority. VBAC is not always the best and safe option for all women.
If you try to give birth vaginally and are at a high risk of complications, it can only result in major problems for you and your baby, some of which are life-threatening too. As a result, it is critical that you discuss these factors with your doctor.
Who should consider a VBAC:
- The likelihood of a VBAC is simply determined by the number of C-sections you have had and the type of C-section you have had previously. If you have only had one C-section before, you might be easily able to undergo a VBAC.
- Having a low-transverse cut on your uterus from a previous C-section is recommended. Your doctor may request a copy of your previous C-section report.
- You should not have had any previous uterine ruptures or scarring from any other procedures or operations.
- Your doctor will also check to see if your pelvis is big enough for a vaginal birth and keep an eye on you to see if you have a big baby. It is quite possible that your kid will not be able to pass through your pelvis safely.
- The next one is as simple as it sounds- Health. You need to be a healthy mom. Both you and your baby must be in good health for you and your doctor to plan a vaginal birth for you. If your doctor feels you are well and completely healthy, you might be allowed to try VBAC even if you are pregnant with twins. You heard it right, even multiple births can be possible.
It is possible that your doctor will tell you that VBAC is too dangerous for you to have a vaginal birth. Any of the following health issues could be a problem:
- Obesity is a problem that affects many people (your body mass index is 30 or higher)
- Preeclampsia is a condition that affects pregnant women (high blood pressure during pregnancy)
- Age is a factor (usually older than 35)
- Your previous cesarean was 19 months ago.
- The fetus is large.
Because difficulties might rise rapidly, the location of your delivery is particularly important.
- You will need to be somewhere where you can be watched the entire time you are giving birth.
- If things do not go as planned, a medical team including anesthesia, obstetrics, and operating room personnel must be on hand to perform an emergency C-section.
- Smaller hospitals may lack the necessary personnel. It is possible that you will need to deliver in a larger hospital.
Make sure you consult your doctor and let him help in deciding your next delivery. If he thinks you are healthy enough for a VBAC, then you can consider it. There are plenty of reasons why you should go for it.
Why you should consider a VBAC:
The majority of women around the globe who attempt VBAC are those who have the ability to deliver their babies vaginally. There are numerous advantages to opting for a VBAC over a C-section. Here are a few to name:
- Hospitalization time is reduced.
- Improved recovery time
- There will be no surgery
- Infection risk is reduced
- There is a lot lower chance you will need a blood transfusion.
- And you might be able to prevent future C-sections, which is beneficial to women who wish to have more children in the future.
How to decide?
Who makes the decision on whether or not you should try for a VBAC? If a VBAC is right for you, you and your doctor together will decide. Consult your healthcare practitioner about the dangers and advantages to you and your child.
Because each woman’s risk is unique, find out what factors are most important to her. The more information you have about VBAC, the easier it will be to determine whether it is best for you.
If your physician indicates you can have a VBAC, there is a strong chance you will be able to do so successfully. The majority of women who attempt VBAC are able to deliver their babies vaginally.
What are the benefits?
You may choose to try VBAC for a variety of reasons, sometimes including the following advantages if it is possible:
- It does not need surgery.
- Blood loss is reduced.
- Improved recovery time
- Infection risk is reduced.
- Your bladder or bowels are not likely to be injured.
- You are more likely to have easier deliveries in the future.
What are the risks?
VBAC has long been seen to be the riskier delivery option for women who had previously had a cesarean birth.
- While some studies demonstrate that VBAC carries risks, particularly in terms of uterine ruptures (break) and that it is one of the most serious risks of VBAC. A rupture can result in blood loss, which is dangerous for the mother and can also harm the baby.
- Women who attempt VBAC, but unfortunately fail are more likely to require a blood transfusion. There is also a higher chance of infection in the uterus.
A study also discovered that the likelihood of developing a huge problem is quite low and that unfavorable outcomes occur seldom.
Researchers looked through and examined the health data of 74,043 women in Scotland, all of those who have previously had a cesarean birth so that they can compare the risk of delivering vaginally against an elective cesarean delivery following a previous cesarean birth.
45,579 of these women had an ERCS and 28,464 had a planned VBAC, with roughly 28% of them having a non-elective repeat cesarean delivery.
While all the women who had a planned VBAC had more health complications, the overall, or absolute, the chance of experiencing an adverse event from either delivery style was minimal, according to the researchers.
Only 1.8 percent of these women who attempted vaginal delivery and 0.8 percent of women who had a second cesarean birth had a major maternal complication, such as a blood transfusion, sepsis, or uterine rupture.
An unfavorable child health outcome occurred in about 8 percent of those who gave birth vaginally and 6.4 percent of those who delivered via elective repeat cesarean birth, such as stillbirth, admission to the neonatal unit, or resuscitation requiring medications or intubation.
Even while the general risk of problems is low, it is vital to remember that vaginal birth has a higher risk.
A uterine rupture occurred in 0.24 percent of women who gave birth via VBAC, compared to 0.04 percent of women who gave birth via ERCS.
Both of these rates are low, yet a woman who chooses to VBAC is six times more likely to rupture her uterine than a woman who decides to have an ERCS.
A blood transfusion was given to about 1.14 percent of women who had VBAC deliveries. A blood transfusion was given to only 0.50 percent of the women who had an ERCS.
Additionally, women who gave delivery via VBAC were more likely to have a puerperal infection and surgical damage.
Women who had a VBAC, on the other hand, were more likely to breastfeed at birth as well as at 6 to 8 weeks postpartum than those who had an ERCS.
Because of the low risk, some women may like to consider attempting vaginal birth after a cesarean birth.
Given the low and overall frequency of negative outcomes, most eligible women (those without contraindications) continue to be good candidates for planned VBAC. Inappropriate, eligible pregnancies, VBAC is becoming more frequently accepted.
In rare situations, a vaginal birth may even lower the risk of maternal complications such as bowel and bladder injuries, which are common after many cesarean births.
Have a C-section scar?
The sort of C-section scar you have on your uterus is an important topic to discuss with your doctor. (It is possible that this is the same type of scar you have on your abdomen, but it is going to be in a different direction.) During a C-section, doctors create incisions (cuts in the abdomen and uterus) in two separate directions:
- From top to bottom, a vertical cut is made.
- A transverse cut runs from one side to the other.
You cannot attempt VBAC if your C-section scar is vertical. When you try to have a vaginal birth, there is a very high danger that your scar will rupture (burst open or tear), causing serious harm to both you and your baby. A C-section will be required.
If your C-section scar is low and transverse, and your other risk factors are really low, your doctor may allow you to undergo VBAC.
Visit your doctor
While there are more health risks with planned vaginal births after cesarean (VBAC) than with a subsequent cesarean birth (elective repeat cesarean section, or ERCS), such as uterine rupture, blood transfusions, and sepsis, the overall risk of experiencing a complication with either delivery method is low. The researchers expect that by sharing all this information, clinicians will be able to better advise pregnant women on their delivery alternatives. So, talk to your doctor about all the factors and make an informed decision that you think is good for you.
