Do VBAC risks outweigh the benefits?
If you've had a cesarean section in the past and are expecting another child, you may be wondering about VBAC -- what it is, why it's chosen and who is a candidate for it. This is one labor and delivery issue that has divided the medical world and moms alike in the past, but there's more knowledge now about the risks and benefits of VBAC to help you make an informed decision. As with any pregnancy issue, the main concern is with the health and wellbeing of your baby and that can mean a change in your birth plan or hopes for delivery. The best thing to do is familiarize yourself with the debate over VBAC, the success rates and the possible complications to help you decide if it's right for you and your baby.
Vaginal Birth after C Section
If you've delivered at least one child by cesarean section cesarean section, each subsequent vaginal delivery would be considered a VBAC. A vaginal birth after c section is different than a normal vaginal childbirth because it must consider the scar from your cesarean surgery, which poses a small risk for you and your baby. Essentially, the fear is that scar in your uterus could rupture during labor and childbirth, complicating delivery and endangering your health.
Luckily, uterine rupture is quite rare for VBACs and most women who attempt a VBAC -- over 80 percent, according to some experts -- will succeed. If you have decided on the VBAC route, your labor will proceed like any other, although you will be watched more closely to make sure your scar remains closed. Electronic fetal monitoring will also ensure that your baby is doing well throughout the labor, so although the straps and mechanisms can be a bit uncomfortable, it's for the good of your baby's health and your own.
Why More Doctors Support VBAC
Once upon a time, the vertical incision that was typically used for c sections made VBAC a dangerous endeavor. The scar that was left through the major uterine muscles that contract during labor would increase the risk of rupture substantially, so many doctors would insist on performing another cesarean to prevent complications. However, today's c sections typically involve a transverse incision, or horizontal incision, which runs across the lower and thinner part of the uterus. If you have a transverse scar, your chances of having a successful VBAC are much higher.
While some women and doctors may decide on a repeat cesarean, the advantages of a vaginal birth entice many moms-to-be. For one, a vaginal birth carries less risk of infection and bleeding complications than a c section, plus the postpartum recovery time is typically much shorter and less painful. The other reason for VBAC is an emotional one: it's not uncommon to feel as if you've "failed" when you submit to a cesarean section, and a VBAC is an opportunity to feel the sense of achievement that you missed out on the first time around.
Aside from a rupture, the VBAC risks are the same as any other vaginal delivery and are generally minimal. However, labor is never completely predictable, and even women who have never had a c section may have to give up on their hope for a vaginal delivery. The point is that VBAC deliveries can be very successful and less risky than you would imagine, but it's important to remain flexible and take your doctor's advice.