Women planning to have a vaginal delivery are often devastated when fate takes an unexpected turn, and their baby is delivered via C-section. To complicate matters, mothers may find their healthcare provider is reluctant to perform a vaginal delivery after a C-section (VBAC) because s/he worries about potential complications.
The good news is that evidence supports VBACs in the right situations, giving women a second (or third) chance at the labor and delivery they wanted the first time around. The American Pregnancy Association states that 90% of women who’ve had caesarian sections are candidates for VBACs (hooray!).
While your choices and emotional well-being are a top priority, it’s worth noting there are plenty of other good reasons to strive for a VBAC if you can. By doing so, you avoid a major surgical procedure, reduce your risk of postpartum infection and enjoy a shorter hospital stay and postpartum recovery.
What Makes a Good Candidate for a VBAC?
Here are the things an OB wants to see to support a VBAC birth plan:
You’ve had a successful vaginal delivery in the past
Whether you’ve had your vaginal delivery before the C-section or as a VBAC, a successful vaginal birth is a positive note in the medical records when determining VBAC status.
You are 35 years or younger
This is not to say that women over the age of 35 years old can’t have a VBAC. However, studies have shown that women under the age of 35 tend to have more successful VBACs with fewer complications.
Your C-section was performed using a low-transverse incision.
The greatest risk of a VBAC is a ruptured uterus, which occurs if the prior C-section incision left the uterine lining weak, causing it to rupture or tear during a vaginal labor/delivery. Low-transverse incisions (an incision made side-to-side on the lower portion of the abdomen) pose the least likely threat of rupture in the future.
On the flip side, if a high, vertical incision (top to bottom) was used, your doctor may not be willing to move forward with a VBAC since these are more prone to rupture.
You’ve had two or less C-sections
The more C-sections (incisions) you’ve had, the higher the risk of uterine rupture. Thus, the best VBAC candidates have only had one C-section (optimal), or two at the most.
The C-section was performed to protect the baby’s health, not yours
The reason for your prior C-section matters to the physician. If you had a C-section because something was happening to the baby (low heart rate, signs of distress, etc.), that’s one thing. Suppose it occurred because your physical labor wasn’t progressing as it should (cervix not dilating, a small pelvis, genital herpes, etc.). In that case, the doctor may advise a C-section for future deliveries.
You‘re free of other uterine anomalies
If your uterus has other anomalies, uterine scarring, or a history of uterine ruptures, C-Section is a healthier delivery option.
You have a healthy, non-risk pregnancy
If your pregnancy is considered high-risk for any reason – gestational diabetes, a breech baby, multiples, history of placenta previa, etc., the doctor will recommend a C-section.
Are you interested in working with obstetricians who support VBACs whenever possible? Contact the all-women team here at Women’s Health Associates to schedule a consult. We look forward to supporting your birth plan and giving you the empowering labor and delivery experience you desire – in the safest way possible.