At least 75% of women who plan a vaginal birth after c-section (VBAC) achieve a successful vaginal birth.
That is a great statistic to hold onto if you are one of the many women who have had a c-section and decide your next birth will be a VBAC.
While many leading health experts recommend VBAC as a safe option for birthing women, it’s not an easy journey to actually achieve a VBAC.
There are many factors playing a part in how likely you are to get your hoped-for vaginal birth.
What Women Need To Know About VBAC
Here are 9 things women should know about VBAC.
#1: It’s Your Choice
After a c-section, many women find they are subjected to subtle and not so subtle suggestions their next birth will ‘need to be’ another c-section.
This often happens long before they even think about having another baby, but the message is planted – your body ‘failed’ and it’s much easier for all if you have another c-section the next time.
It’s not uncommon for women to struggle to find a care provider who is supportive of VBAC or who even takes on women planning a vaginal birth after c-section.
You may constantly hear negative comments about having a VBAC but the choice is ultimately yours. But it’s likely to be up to you to fight for your right to have one.
#2: You'll Need To Be Prepared
In a perfect world, women wouldn’t need to arm themselves with enough information to virtually qualify them as a medial professional in order to achieve a personal choice of giving birth vaginally after a c-section.
But unfortunately, that is true in most cases. Be prepared to have to advocate and fight for your right to have a VBAC every step of the way. Depending on where you choose to give birth and the stance on VBAC, you may find yourself telling each person you have contact with about your right to informed consent.
The American College of Obstetricians and Gynecologists (ACOG) has recommended women should be supported to choose a VBAC where possible, and says restrictive policies around VBAC should not be used to force women to have repeat c-sections.
#3: It’s Not As Risky As A Repeat C-section
Vaginal birth does come with risks, but research shows that vaginal birth is safer and less risky than c-section for both mothers and babies.
Having a c-section is major abdominal surgery. There is a long list of risks for women and babies associated this surgery yet it is one of the most commonly performed operations in the world.
The risk of maternal postpartum death is 3.6 times higher after c-section than after vaginal birth.
The neonatal mortality rate is higher among babies who are born via c-section compared to those born vaginally.
A repeat c-section also increases a woman’s risk for complications in any future pregnancies, particularly things like placenta previa or placenta accreta. These complications will likely require a c-section as well.
#4: VBAC Is Best For Baby
Vaginal birth after c-section has positive benefits for your baby. Labour begins when your baby is ready to be born, ensuring the lungs are mature and the brain has developed.
Research has long been looking at what causes labour to start and discovered your baby’s lung maturity is one of the key factors.
During labour, your body is producing stress hormones which helps your baby prepare for life outside the uterus. Contractions have a similar effect and during birth, help to push fluid out of your baby’s lungs, ready for them to take their first breath.
Experiencing a vaginal birth allows your baby to be exposed to your beneficial bacteria as well as antibodies. Science is really only just beginning to understand the effects of disrupting bacteria transfer during birth and its impact on short and long term health.
Find out more about the benefits of natural birth for babies.
#5: Your Uterus Isn’t More Likely To Rupture
The number one reason why VBAC is considered risky is due to the possibility of the uterus rupturing along the line of the old scar.
Uterine rupture is a rare event and occurs in about 0.2% vaginal births after c-section.
Women are more likely to need a c-section for other complications such as cord prolapse or severe bleeding, than for uterine rupture. Women who have had multiple previous c-section are often told they have an increased risk of uterine rupture.
Research has since shown women who have had three or more prior c-sections had similar rates of success and complications as those women who have had one prior c-section. VBAC after multiple c-sections may be a safe choice for you.
Uterine rupture being a big risk for VBAC is one of a few myths we debunk here.
#6: Care Provider Matters
We know women who choose midwifery led models of care are more likely to have a spontaneous birth with no interventions.
It follows that women who have chosen midwifery care for a VBAC are more likely to achieve a vaginal birth than those who are under obstetric care.
A study published in BJOG showed this to be true, comparing vaginal birth rates in women planning VBAC at home versus in an obstetric unit and found the planned VBAC at home were significantly more successful with their birth outcome.
A home birth might not be your choice but it pays to know that midwifery led models of care are optimal for helping you be one of the 75% of women who have a successful VBAC.
You might decide to hire a private midwife for pregnancy care and act as support during labour. A doula is another option for women who can’t access private midwifery care.
If hospital is your only option, talk to the care providers about policies and restrictions around VBAC as early in your pregnancy as possible, so you don’t have nasty surprises later on. If you have the option of travelling to a different hospital which is VBAC friendly, it might be the best choice.
#7: Ticking The Boxes
You may be told you are more/less likely to be successful in achieving a VBAC based on a number of factors, such as having your baby being head down at term, labour starting on its own, having a low transverse incision, and you don’t have a medical condition which contributed to your previous c-section.
The issue today is in many cases, women find themselves classed as ‘high risk’ simply due to their age, body mass index and racial background. Whether this risk status is reflective of their actual health or not, it can affect their ability to successfully find a care provider who will take on a VBAC.
What the statistics can tell us is how many women from certain groups have had VBACs in the past but they can’t tell you what your VBAC will be like.
#8: It's A Different Recovery After Birth
Recovery after surgery is no walk in the park. All the painkillers in the world can’t prevent you from having to acknowledge at some point an incision was made into your uterus, your abdominal muscles were pulled out of the way, a surgeon pushed your internal organs around, and a few other layers of tissue snipped and cut.
In most cases, women who have had a c-section and a vaginal birth will report the recovery after the vaginal birth was a lot easier, especially in the early days. Most likely you are able to get up and walk to the shower or toilet within a short time of giving birth.
After a vaginal birth you may feel tender, bruised, like you ran a marathon, and even have some stiches, but you won’t be recovering from surgery. Which makes a big difference to how you enjoy the first hours and days of your new baby.
#9: It’s Totally Doable
It’s not unlikely you will spend a lot of time being told you won’t get your VBAC.
Most women chose to VBAC because they want to have the birth they missed out on last time. It’s true a positive and empowering birth experience can be a big healer for previous trauma. Not all women do feel that way but most find a VBAC helps to resolve their sense of loss and guilt a previous c-section may have left them with.
Emotionally and physically pregnancy can be tough on many women – it helps to tap into the vast amount of stories and positive encouragement available online and in books today.
Knowing there are women who have walked this path before you and achieved their dream birth can make a big difference to your inner resolve and strength. Read our article full of advice from VBAC mamas who have been there and done it.