Keen for a VBAC? Here's some info to get you started!

So for one reason or another, your previous birth was a c-section delivery. C-sections are great! They are an amazing way to help get your baby into this world safely!

But when it comes to your next birth, you may be wondering if you have to have another C-section. Well, there are many answers to that question – and a lot of them are personal to you, your situation and your healthcare team. But here is some useful information that can help you start a discussion with your midwife, GP or Obstetrician and make an informed decision about the best path for this birth.

What is a VBAC?

A VBAC is a Vaginal Birth After Caesarean section. According to NSW Health “most women who have had a previous caesarean section can safely give birth vaginally in their next pregnancy”.

Is a VBAC an option for me?

As stated above, that is a very specific question related to you and your situation, and what your healthcare team is comfortable with. However, if you have previously had a lower segment c-section (so the scar line is low across your abdomen and pretty much hidden by your undies), then it may be an option. If your pregnancy has been relatively straightforward with no major complications, that contributes to the chances of a successful VBAC. Going into labour spontaneously (i.e. not having to be induced) is another factor which greatly helps your chances of a VBAC.

When is a VBAC not an option?

Just like in any pregnancy, there are certain medical conditions where a vaginal delivery is not recommended such as breech position and placenta previa, so a c-section is encouraged. If you have had 3 or more previous c-sections, or a c-section within the last 18 months, then it will usually be recommended to have another C-section. If your previous c-section was complicated, they had to do an alternative cut (such as down your abdomen rather than across), or you have had a previous rupture of your uterus, then again, a repeat c-section will usually be the safer alternative.

Are there any additional risks associated with a VBAC?

There is a small (1 in 200) risk of your previous c-section scar weakening or separating (known as uterine rupture). Sometimes there is also a small increase in the need for a blood transfusion (i.e. extra blood) after you have had your baby.

What will happen during my labour if I opt for a VBAC?

Because of the risk outlined above, during your labour you will be closely monitored once contractions are established. Apart from that, most labours are the same as anyone else’s. If labour slows, syntocin (a drip) may be used carefully to help your contractions along. Pain relief options, including epidurals are the same as well! As with any vaginal delivery, if the baby becomes distressed, an emergency caesarean may be required.

Can I be induced if I choose to have a VBAC and don’t go into labour spontaneously?

The risk of your previous scar opening is increased with an induction, so usually the answer is no. However, it’s best to speak with your healthcare team as it may depend on the method of induction used, along with your individual circumstances.

What can I do about a VBAC?

If you think you would like to consider a VBAC, have a chat with your midwife or Obstetrician early in your pregnancy. If you feel like your questions are not being answered in the way you would like, or you do not feel supported in discussing your options, seek a second opinion. Eat healthy as much as possible, and stay active during your pregnancy (we hear pregnancy classes at Bump Physio are amazing!). And enjoy the pregnancy (we do know this is often easier said than done!).

If you have any further questions about VBACs, please have a chat with your healthcare team. And remember, at Bump Physio, whilst we can’t offer specific medical advice, we are always here for a general chat if you need us!