The percentage of women having a vaginal birth after a cesarean delivery has been rising over the past several years. When deciding whether this is the right option for you, it’s important to understand all the benefits and risks of this procedure.
Benefits of a VBAC
- No abdominal surgery resulting in a quicker post-birth recovery
- Lower risk of infection
- Less blood loss through the delivery process
Multiple cesarean deliveries can lead to future health issues. Occasionally, women having multiple C-sections may deal with bladder or bowel injury, issues with the placenta in future pregnancies, and the potential need for a hysterectomy.
Risks of a VBAC
As with any procedure, the risk of blood loss and/or infection is a possibility during a VBAC. A more serious, but rare, complication is the potential rupturing of the uterine scar from a previous C-section(s).
An important detail to discuss with your Obstetrician is the type of uterine incision that you have from your previous C-section. Typically, there are three different types of uterine incisions and this information should be documented on your medical records.
The three types of uterine incisions are:
- Low transverse—A side-to-side cut made across the lower, thinner part of the uterus. This is the most common type of incision and carries the least chance of future rupture.
- Low vertical—An up-and-down cut made in the lower, thinner part of the uterus. This type of incision carries a higher risk of rupture than a low transverse incision.
- High vertical (also called “classical”)—An up-and-down cut made in the upper part of the uterus. This is sometimes done for very preterm cesarean deliveries. It has the highest risk of rupture.
It is important to note that the uterine scar is not related to the look of the incision scar you can see on your skin. If you have changed OB-GYNs from your previous c-section, it is very important to have your medical records transferred so your current provider is well-equipped to help you make a well-informed decision regarding VBAC.
The Importance of Being Flexible
After discussion with your provider, you may have decided to plan for a VBAC or a C-Section. Regardless of what option you have chosen, it’s important to remain flexible. There are situations that can occur during labor that may warrant a change in plan.
The necessity of labor-inducing drugs may lessen the chance of a successful VBAC. If you had been planning for a C-section and you go into labor prior to your scheduled delivery, if you and your fetus are healthy, it may be best to move forward with a VBAC. The importance of flexibility in this situation seems like an appropriate reminder of the importance of flexibility as a parent!
We encourage you to have a candid conversation with your Obstetrician to determine whether this is the best choice for you! Our team at the Center for Women’s Health would be happy to help guide you through this important decision!
SOURCE: American College of Obstetricians and Gynecologists, Vaginal Birth After Cesarean Delivery (VBAC)