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VBAC: Vaginal birth after a C-section

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VBAC, vaginal birth after C-section, pregnant woman
Pregnancy and birth are very personal processes, and each woman needs to decide what is best for her needs.

However, sometimes the option of having a C-section is out of your control, and if you underwent a Caesarean with your first child, you may not wish to repeat the process with your second.

Here, midwife Anne Richley explains everything you need to know about having a VBAC, or vaginal birth after a C-section.

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

Will I be supported?

Doctors and midwives may vary in how supportive they are of your decision, if you feel they're not supportive, ask them why. Also, make sure you fully understand the reasons for your previous Caesarean. It's important to be well informed. You can always ask for a second opinion from another doctor or midwife.

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Having a Caesarean section can be life-saving for both mother and baby, but it's important to recognise when it's necessary and when there's a safe alternative. Ultimately, the decision is yours whether you have one or not. For more information and support from the NCT, call 0870 444 8707, or visit VBAC supporters at vbac.org.uk.

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