Vaginal Birth after Caesarean (VBAC)

VBAC stands for Vaginal Birth after Caesarean and is, as the term denotes, when a mother has a natural birth following a caesarean section. Many mothers find that they are monitored more closely during labour following a caesarean, especially in terms of foetal monitoring, to keep an eye on the baby’s heartbeat as well as contractions.

What is the main difference between VBAC and normal childbirth?

There are a few important differences between VBAC and normal childbirth, as described below:

• Some women who have VBAC may experience a uterine rupture due to scars from the previous caesarean tearing, unlike normal births where there is minimal risk of this compared.
• A VBAC will require maintained monitoring of the foetus as well as your own heart rate and rate of contractions.
• With a VBAC the hospital may encourage you to use a birthing pool in order to cope with the intensity of contractions.

What can I have as an alternative to VBAC?

A planned repeat caesarean is, if you already have one or more babies, sometimes an option but you may need to go private for this.

What are the advantages of VBAC?

The advantages of VBAC are described below:

• There is less risk of having another caesarean.
• You will experience less pain after the birth.
• You will have a shorter stay in hospital.
• Your baby is less likely to have breathing problems.
• You may have a sense of achievement.

You will be able to discuss the advantages of VBAC with your midwife or doctor if your last baby was delivered by caesarean. Once you have had one successful VBAC you are more likely to have subsequent successes.

What are the disadvantages of VBAC?

The disadvantages of VBAC as follows:

• You may experience pain and sensitivity in the vaginal area and back passage.
• You may find that your urine leaks during the first three months after a VBAC.
• Some women have their uterus slip down through their vaginal wall.
• Prolapse is twice as likely to happen during a VBAC.
• You may need a blood transfusion.
• There is the possibility of an infection in your uterus after the birth.
• There is a small chance that you could rupture your uterus.

Can I have a VBAC home birth?

Your doctor or midwife may advise you against having a VBAC at home as there are risks associated which may require immediate medical intervention, best offered in a hospital environment. This is mainly due to the small risks of the uterus rupturing, which could be handled more easily in a hospital setting.

If you do want to have a VBAC at home it is best to speak to one of the senior consultants or midwives, who can on the various options available. The senior midwives can give advice on the safest way to have your baby according to your individual circumstances.

What is the outlook if having a VBAC for my next baby?

The outlook is positive as many women have had a successful VBAC’s with their subsequent children. There are factors to consider such as pregnancy complications which might make it difficult for you to have a VBAC. If you have had a caesarean before but do want to have a VBAC there is still a good chance that you can achieve this. In most cases women have had a positive VBAC and delivered healthy and happy babies.

Can all women have a VBAC?

There may be some circumstances where a VBAC may not be possible such as in cases where the mother has had more than one caesarean. Most healthy women with normal pregnancies can successfully achieve a VBAC. Your doctor will advise you if a VBAC is the best option according to how well your pregnancy is progressing.

Women who are having more than one baby may also be advised against a VBAC due to the potential risks. Other factors include if your babies are too big or if your general health does not permit you a VBAC.