Provided the mother and baby are in good health, it is not unreasonable for some women to consider vaginal birth after a caesarean section (VBAC). If labour progresses smoothly, then about 70% of women will have a successful VBAC.
The advantages of this are that it avoids surgery and its associated risks, potentially less blood loss and faster recovery. Once a successful VBAC has been achieved, then VBACs can be attempted for future deliveries.
Having said that, VBACs are not without its specific risks with uterine rupture being the main one. If uterine rupture were to occur, the risk of fetal mortality (death) and morbidity (injury) is high, and especially permanent brain damage (cerebral palsy).
Maternal morbidity and mortality are likely to occur too.
The risk of uterine rupture is less than 1% if you have had one previous cesarean section. If you wish to attempt a VBAC, it is best to discuss the risks and probability of success with your gynaecologist who would be in a better position to advise you accordingly based on:
- the estimated weight of your baby
- presentation of the fetus
- location of the placenta
- number of caesarean sections in the past
- any previous uterine surgeries
- the number of successful VBACs in the past
- your pelvic dimensions
- and the standard of monitoring of labour in the hospital of your choice.
If you have had 2 previous caesarean sections in the past, then a VBAC would be contraindicated as the risk of uterine rupture would be high.
The most important thing I tell my patients is that if a caesarean section is deemed to be the safest mode of delivery after taking into account all due considerations, then so be it.
Delivery is only one day and you will have a lifetime to look after your baby, so you don't really want to make the wrong decision (despite your gynaecologist's advice) and take unnecessary risks as you will have to live with the dire consequences.
