VBAC is simply a vaginal birth of a child after a previous caesarean.
The only way that VBAC differs from other first time labours is the small increased risk of uterine rupture. Approximately 0.2% higher than that of a normal labour. This is very small when you consider that you are 30 times more likely to require a emergency caesarean for situations such as acute foetal distress, cord prolapse or ante partum hemorrhage.
The research also shows that approximately 75% of uterine ruptures occur in women who have never had a cesarean and of the 25% that have, 1/3 do not rupture at the scar line.
Planning a vaginal birth after a previous caesarean (VBAC) has many benefits. A vaginal birth avoids the risks of surgery and anesthesia and improves the health outcomes for the woman and her baby. The research shows that babies greatly benefit from the process of a natural birth.
7.4% Private Hospital VBAC Success rates (NSW)
13.44% Public Hospital VBAC Success rates (NSW)
(Source: NSW Mothers & Babies Report 2009)
Check your local hospital c-section rates and VBAC success rates here in our Birth Services Revealed.
- Avoiding the risks of surgery
- Getting to hold your baby before any one else
- Having skin to skin contact straight away
- Giving your baby the best start in life with the benefit of labour
- The contractions stimulate the baby and get them ready for birth,
- Passing through the birth canal gets their lungs ready to take their first breath
- The compression of the skull fires off neurons in the brain increasing its development.
- Waiting for labour to start naturally also helps prevent babies from being born prematurely and greatly reduces them from being separated from their mothers.
- With a natural birth, especially one free of intervention you have a lot more control over who attends your labour. Eg siblings and support people
- VABC women often express feelings of empowerment, accomplishment, exhilarated, control and a “I can do anything’ attitude that is very helpful when becoming a mother for the second time.
- Having a VBAC can also be a very healing process for someone who has had a previous caesarean and doesn’t feel good about the experience.
- 0.2% higher risk of uterine rupture
- Most hospitals require continuous foetal monitoring.
- Most hospitals require you to progress through your labour very quickly, which can make birth a stressful experience.
One of the biggest problems in having a VBAC in Australia is the attitude of some care providers and the policies of most hospitals. Where the VBAC women should be treated with extra time and encouragement, most are restricted with the use of continuous foetal monitoring and strict time frames of progression that even a first time mother would have trouble meeting. This can create a lot of stress and lead the women back down the path to another caesarean.
- Find out what your care providers policies on VBAC are
- Negotiate no continual foetal monitoring or intermittent, ask for a midwife and a doppler
- Do your research, most private hospitals VBAC success rates are under 10% some as low as 2.1%
- Find a care provider that believes in VBAC and encourages and supports you during your labour
If you are choosing to have a VBAC because you want what is best for your child or to help heal a previous bad birth experience, the most important thing you need to do is carefully pick your place of birth.
If you are told that you can’t have a VBAC for one of the following reasons, we suggest getting a second opinion from a care provider who has a good VBAC sucess rates.
- History of slow labour, overdue, foetal distress, placenta praevia, position of the fetus or multiple birth.
- History of 2 or more caesareans as there is little or no difference in the morbidity figures for VBACs after 2 or more caesareans and the vaginal delivery rate is almost the same as for women with only one previous caesarean.
- Cephalo-pelvic disproportion (CPD) or big baby.
I decided for the birth of my second child that I really wanted the chance to have a vaginal birth after having to have an elective Caesarean for my first child; this was due to a low lying placenta (placenta previa). I knew then my wish to have a vaginal birth became extremely limited and prepared myself for the Caesarean.
A friend of mine invited me to a meeting run by the Central Coast Maternity Coalition where women shared their birth stories and one women spoke of her VBAC experience at John Hunter Hospital. It was there that a midwife recommended John Hunter Hospital if I wanted to try for a VBAC. Read More.
A VBAC Primer: Technical Issues for Midwives – by Heidi Rinehart, MD
Women pregnant after a previous cesarean section have special needs and concerns.
The VBAC and Cesarean Prevention Handbook
Part of Midwifery Today’s Holistic Clinical Series, The VBAC and Cesarean Prevention Handbook will teach you how to work with VBAC moms and how to prevent cesareans in the first place.
Vaginal Births After C-section Are Not Necessarily Riskier in a Birth Center
While recent research concluded that VBACs are riskier in birth centers than the hospitals, the author points out some of the other problems that the authors of the study failed to note, such as the fact that being in a hospital increases the risk of a cesarean and on future pregnancies.
http://www.birthrites.org/ – a website offering information and support following a caesarean and for women wanting a VBAC. Download their 52 page Birthrites booklet, crammed full of information detailing the physical and emotional aspects of caesarean birth, and the challenges of planning future births – exploring the VBAC option in some detail, but also outlining ways to plan a positive caesarean. The booklet considers issues in a before/during/after format to enable women to make informed choices and provides relevant information in relation to caesarean section birth.
Check your local hospital VBAC success rates here in our Birth Services Revealed database.
HIGHEST VBAC SUCCESS RATE IN NSW (2009)
Bega Hospital 38.1%
(Source: NSW Mothers & Babies Report 2009)