VBAC isn't exactly catchy as a name, but it beats Vaginal Birth After Caesarian. For many women, the reaction they have had from health professionals when they've requested one has implied that VBAC is almost as clunky and awkward as it sounds. But now opinion is beginning to change.
Why has VBAC been regarded as problematic?
In the past, once a woman has had a caesarian, it has been regarded that another caesarian is preferable to 'natural' vaginal birth, where the strain of labour might rupture a previous caesarian scar in the uterus. (Some women who have spoken to their doctor and have voiced wishes to try for VBAC might see the phrase 'scar try' on their notes.)
Now, however, it is regarded that a woman who has had one caesarian before which was low transverse, is less likely to suffer complications from VBAC than from another caesarian operation.
Why not have a second caesarian?
Caesarians are great. They save lives, not only for many babies but in some cases, for mothers, too. However, a caesarian is in itself, a major operation.
Whether you have a caesarian under general or local anaesthetic, your body needs the minimum six weeks to recover, at a time when a new baby demands and/or inspires you to be out and about, experiencing motherhood.
Having a vaginal birth after a caesarian increases the chances of the mother having future successful births. Repeated caesarians are not advised.
There can be medical implications for the mother and for future babies with repeated caesarians, too.
There is nothing wrong with having a caesarian, but it does mean the body cannot naturally heal itself as quickly as with a 'natural', vaginal birth.
Feeling 'cheated'
Some women feel they have been cheated out of the full birth experience if they have previously had a caesarian. Others feel guilty that they have in some way not worked hard enough in labour. This is one of the big motivations in trying for a VBAC, beyond medical reasons.
Risks in VBAC
The risks that a rupture will occur is less than one per cent, during VBAC, though it is higher if a mother has to be induced.
Fetal heart-rate patterns are an important indicator in cases of rupture (either major tearing of the previous uterine scar, or minor undoing of the scar, which is less dangerous). VBAC mothers will probably find that the fetal heart-rate is more closely monitored during labour, than for mothers having routine births.
Health professionals have mixed views on whether a VBAC is acceptable in a home birth, though some believe it is preferable even to a hospital VBAC.
For more information about Vaginal Birth After Caesarian, visit www.vbac.org.uk and check out the ThinkBaby article on vaginal birth after caesarian.
