You have had at least one baby in the past by caesarean section. This time you have a choice. You can have a normal vaginal delivery or another caesarean section. It is common for pregnant people to have a vaginal birth after a caesarean section. This type of birth is often referred to as a ‘VBAC’ (sounds like vee-back).
Of the people who have had a caesarean section in the past, about three quarters (3 out of 4) of them safely give birth through a normal vaginal delivery for their next baby. Some people try to have a vaginal delivery and are not successful. If this happens, we would do another caesarean section.
Why is it better to choose a vaginal delivery?
There are many reasons why a vaginal birth may be better than another caesarean section:
- Less blood loss
- Less chance of injury and infection
- Less pain after birth
- No chance of the problems that are possible with surgery
- A shorter time spent in the hospital
- A faster, less painful recovery
- Less chance of any breathing problems for your baby
- Less chance of problems with future pregnancies
What are the risks of having a vaginal delivery?
Your previous caesarean section left a scar on your uterus. This is a weak area and can tear during labour. This is called a uterine rupture. The chances of this happening are very small (1 in 200). If it does happen however, it can be life-threatening for both you and your baby. We would need to do an emergency caesarean section. You could need a blood transfusion, or even a hysterectomy. The baby could be harmed from not getting enough blood supply and oxygen.
If you have had more than one caesarean section, the chances of problems and uterine rupture is slightly higher.
When is a VBAC not for you?
Sometimes a vaginal birth after a caesarean is not the best choice. It depends on your medical history or current health status. Your doctor or midwife would suggest a repeat caesarean section in this case.
Situations where you should not try to have a vaginal delivery:
- A previous caesarean section where the incision in the uterus was made in the shape of a ‘T’. Your doctor or midwife will need a copy of your previous hospital records to check and see what type of incision was made.
- Previous surgery on your uterus
- The placenta is in a position that does not allow for a safe vaginal delivery
- A uterine rupture in the past
- Your baby is in a breech position
What kinds of things are done to make sure everything goes okay?
We take precautions to make sure that your delivery is safe. for both you and your baby.
- You and your baby are monitored throughout your labour to check on the baby’s well-being. This includes electronic fetal monitoring which allows us to monitor your contractions and the baby’s heart rate at all times.
- We start an intravenous (intra meaning ‘into’ and venous meaning ‘vein’ – commonly called an IV). We use a needle to put a small flexible tube into a vein in one of your arms. This is so we can give you medicines if needed.
- We take blood tests.
- We may give medicines for pain or to move your labour along.
What if you try the VBAC and are not successful?
There is always a chance that you might not be successful in having a vaginal delivery. We would proceed to a caesarean section. This usually happens when your labour contractions slow down, your labour is not progressing, or we are worried about the baby’s well-being.
What if I go into labour and I am scheduled for a caesarean?
About one third of people who planned another caesarean section will go into labour before their planned surgery.
You may choose to try for a normal vaginal delivery or you may choose to proceed with the caesarean birth as planned (emergency caesarean section).
It’s good to ask
Ask your doctor or midwife if vaginal birth after a caesarean (VBAC) is right for you.
In most cases, a VBAC is a safe option for both you and your baby.