Vaginal birth after a C-section

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Why is VBAC (Vaginal birth after a C-section) important?

Some women feel 'robbed' of their chance to experience giving birth vaginally and feel strongly about avoiding a Caesarean the next time round. Some may have felt out of control with their first C-section, while others may want to avoid another one due to the inconvenience of not being able to drive, lift and so on, especially when there's both a toddler and a newborn baby to look after.

What are the risks of VBAC?

The main risk is the serious, but very rare, breaking down of the scar from the first Caesarean. The concern is that the scar causes a weakness in the muscle, and the contractions during labour could cause the scar to become thin or start to separate. So long as there's no bleeding, this usually doesn't cause a problem.

The main complication is when the scar opens, causing 'uterine rupture'. If this happens, the woman will need to have a Caesarean section very quickly. The risk of it happening, though, is approximately 0.3 per cent, three in 1,000 of all VBAC labours so it's still safer to go for a VBAC than a repeat Caesarean, which has extra risks attached, such as infection, injury, infertility, pain, blood clots, and haemorrhage.

Can I have a VBAC this time?

Most women who choose VBAC will achieve one. Assuming the baby's well positioned and there are no medical problems, VBAC is a safe option.

The chances of having a VBAC vary greatly between areas, some areas achieve over 90 per cent and others just over 50 per cent. There are ways to make a vaginal birth more likely:

Start labour naturally
Avoid having your waters broken
As long as labour is progressing, don't be tied to strict time limits on how long the first and second stages should be
Have one-to-one support in labour
Keep upright during labour

By Anne Richley, midwife