Vaginal Birth After Caesarean (VBAC) Choices, challenges and truths.
Updated: Jan 15, 2020
Since 1985, the World Health Organization (WHO) has recommended that a population caesarean section rate of 10–15% is expectable to ensure mortality rates are kept low for mothers and babies.
In Australia today we have a caesarean rate sitting around 33%. Many individual Obstetricians and hospitals have a caesarean rate much higher than that.
The reasons why this number is so high in Australia and in fact globally, is not the focus for this article, as its deserving of its own conversation and time.
However, with so many women giving birth to their first child via caesarean section, it’s never been more important to get educated if you want to achieve a vagainl birth after that caesarean (VBAC) as there are many medical practitioners who do still try and steer their pregnant clients back into the theatre.
With so many people assuming a natural delivery is off-limits if your first baby was born by caesarean and that saying “once a caesarean always a caesarean” still ringing in many ears, it can be challenging to work around your options. I do know that with the right conditions, care provider, education and lot of support you can have a vaginal birth after a previous caesearn.
There are many misconceptions around VBAC's and many women become swamped with the many varied options and opinions.
A planned vaginal birth after a caesarean should, by rights, be recommended for all women who are healthy and have no serious indicators for a necessary second or third caesarean. Previous reasons for a caesarean like 'Cephalopelvic disproportion' (baby to big) and 'failure to progress' should not be stand-alone contra-indications for a trial of labour (TOL) next time around.
It is important first that you understand why your c-section occurred. We know some women and their partners are upset and confused by their previous caesarean, even traumatised.
Its good to formally debrief that experience and enter into a re-education about labour and birth to clear the way for a new experience.
Finding a supportive care provider is imperative, so when considering where to birth and with whom, make sure you ask your potential Doctor or Midwife a lot of questions, including what their polices and procedures are on VBACs and what their stats on Caesareans and VBACs are.
Hiring a doula can increase your chances of a successful VBAC. We believe that with the right support, re-education, positive language, care, honesty and love, most women can go on to have a beautiful vaginal birth. You must be surrounded by people who believe in you and your VBAC vision.
Creating a clear VBAC birth plan and creating plan B should you need it is important and a great way for you to clarify your needs and desires with your car provides.
Should another caesarean be truly necessary, we want you to feel in control of having better understood the labour process, so that you can come away feeling empowered, knowing you did your best.
Image courtesy of @spiritysol