Vaginal Birth After Cesarean
(VBAC)

Posted: May 5th, 2020

Vaginal Birth After Cesarean
(VBAC)

Introduction
There has been an increased record on cesarean birth rates in the United States over the past two decades where an estimate ratio of one in every three babies that are born through surgical procedures, cesarean delivery is applied. Women who are at low risk of birth complications have been recorded to increasingly prefer cesarean delivery which exposes them together with their babies to harm.
Risks of VBAC
Childhood chronic illnesses and complications of the placenta in subsequent pregnancies are among the risks that women who go through the cesarean procedure are exposed to. Many of these women have limited access to vaginal birth due to a variety of reasons which include lack of an organized emergency response team by the healthcare facility incase of complication during delivery. Another reason could be that the healthcare facility wants to avoid litigations and law suits that may follow as a result of maternal mortality. Many women who have had the cesarean delivery are at a higher risk of uterine rupture during labor, however, it is a rare occurrence recorded in about 1 in every 500 women. Another major risks associated with VBAC is maternal and fetal complications which can be minimized in the case a mother had chosen to continue with a cesarean procedure. One of the complications is heavy bleeding which might cause the uterus to be removed a procedure known as hysterectomy. Without a uterus, the woman has no chances of getting pregnant again which may be very traumatizing and may lead to psychological problems such as depression.

Benefits of VBAC
VBAC has its benefits in that, many women are eligible with a high success rate, however, these benefits are limited. One of them includes limited complications since no surgery is involved such as damage to the bladder or the bowel. Another benefit is faster recover and a shorter stay at the hospital which will limit the probability of nosocomial infections and consequently the cost of healthcare. There are lower rates of maternal morbidity in the case where no complications are encountered. Finally, if the VBAC is successful, there will be fewer to zero complication in the subsequent pregnancies.
Advice to women considering VBAC
For a woman considering VBAC, I would recommend that she takes a look at the following factors which; she should consider whether she has had a vaginal delivery before and how successful it was as this will promote her chances for a safe vaginal birth. Secondly, she should consider the type of uterine incision that was used on her before the cesarean delivery because low transverse incisions are used in most cesarean deliveries. A woman who has had a low vertical incision is a higher chance of a successful VBAC than one who has had a high vertical incision for it increases chances of uterine rupture during labor. If she has had a previous case of uterine rapture, VBAC is not an option for her. Thirdly, she should consider the number of cesareans she has undergone as more than two procedures limits the probability of the healthcare facility to permit VBAC.
Fourthly, she should consider her health concerns, the onset of any health complications such as complications of the placenta, multiple embryos (three upwards), or abnormal positioning of the embryo, having a VBAC would expose her to risks. Fifth advice would be considering whether she would need to be induced to labor, if so her chances are limited. Lastly, it would be wise to research on the healthcare facility they plan to have their delivery, some facilities may not be well equipped to provide an emergency cesarean delivery in the case of complications. Most importantly, when having a VBAC, home delivery is highly prohibited.
Conclusion
In conclusion, a woman considering VBAC should exhaustively discuss with the healthcare provider on the available options, health concerns as well as expectations early enough to detect any potential threats.