Vaginal Birth After C-Section (VBAC)

Vaginal Birth After Cesarean (VBAC) - Fernandez Hospital

She believed she could. So, she did.

Many women believe that the only way to have their child after undergoing a Caesarean section is another Caesarean section. This is not true in all cases. Studies show that about 60 to 80% of women who attempted a trial labour after Caesarean section (TOLAC) had successful normal deliveries. VBAC or Vaginal Birth after Caesarean is a formidable mode of birthing for women with uncomplicated pregnancies.

What is VBAC?

VBAC is a term used for having a normal vaginal birth after having undergone a Caesarean section previously. It is an achievable task and depends on several factors.

Most women fear for the safety of themselves and their babies. VBAC is a safe means of birthing in the absence of underlying complications. All you need is an optimal environment with the right guidance and support.

Undergoing a C-section can be a pretty traumatizing experience for some women as it paralyzes them into a singular position and their choices and wishes aren’t well respected.

Trying for a normal birth the next time after a C-section is natural. You can opt for a VBAC in the absence of the following conditions:

  • Obesity (Body Mass Index higher than 30)
  • Pre-eclampsia (high blood pressure during pregnancy)
  • Age above 35 years
  • C-section in the last 19 months
  • Very large foetus

VBAC in your current pregnancy is also a much safer choice for pregnancies you wish to have in the future. Every Caesarean you have increases the percentage of internal scar tissue, this makes it quite difficult for the placenta to grow and attach normally. Increase in the amount of scar tissue could lead to increased possibility of adhesions wherein nearby tissue or organs grow together. This further leads to the caesarean becoming risky in future pregnancies.

What role does a professional midwife play during VBAC?

A professional midwife plays a vital role in ensuring a smooth and safe VBAC. She is a warden of natural birth and encourages you in every step of the way and through all the highs and lows.

They educate you thoroughly about the concept of VBAC to help you better understand what you’ll be going through and inform you of all the preparation you’ll need to have a successful VBAC.

Midwives are highly skilled individuals who are trained to provide emergency care and detect complications early along with facilitating normal birth. Midwives are known to be the safest providers of care to mothers during and after labour. They respect your wishes and choices and answer the smallest of your queries in detail. A woman in labour along with a professional midwife make an unbeatable team ready to face all the challenges that come their way with complete dedication and confidence.

 

We at Fernandez Hospital are strong endorsers of natural birthing and the benefits it has for both the mother and the child. To encourage you to opt for a VBAC and to emphasize the beauty of the process, we’d like to help you understand VBAC better with the story of a very strong young lady called Muqqadas.

Muqqadas was a petite young woman who specifically sought Fernandez Hospital after a lot of research. She was aware of the fact that Dr Evita is considered a legend for her tremendous support and encouragement to natural birthing. Muqqadas had undergone a traumatic C-section experience in her first pregnancy and was therefore adamant that she would not put herself or her child through it again.

She discussed in detail with one of our professional midwives the chances of having a VBAC and the preparation she would need to undergo. Being a slim woman with a low haemoglobin count, she worked on increasing her weight and haemoglobin level. Our team of professionals employed several strategies to prepare for the birth; being able to move around in labour was really important to Muqqadas so she wished to avoid continuous monitoring, a factor that had really limited her at the time of the first birth. Our team managed to source a CTG machine which could be used in water, so we were able to provide her with the option of a water birth with constant monitoring. A happy compromise, to say the least.

She also was in touch with our counsellor to aid in preparing strategies for labour. Her designated midwife was constantly in touch with her to guide and support her. She knew that she couldn’t be guaranteed a VBAC but was also aware of the fact that her wishes and choices would be fully respected, and no intervention would be conducted without her complete consent at Fernandez.

She was due to give birth around Ganesh Visarjan a fact that made her extremely anxious. She was sure that she would go into labour that very day amidst all the commotion, that is exactly what happened. She called the midwife late Saturday night informing her that her water had broken and was asked to come in due to transport concerns. She saw a midwife in the Antenatal clinic where she underwent a series of checkups which were all normal. Following this, she was sent to the room waiting for her contractions to begin.

When her labour increased the next afternoon and our team was almost ready to enter, the baby’s heart rate slightly increased. Although no temperature was present, the designated midwife recognized all the impending signs of a developing infection. Unfortunately, Muqaddas developed a full fever and a raised heart rate which caused the entire team understandable concern. The baby’s heart rate remained stable and there were no other issues at that point. A waterbirth could not be considered at this point. She was reviewed at regular intervals by the entire team. Her labour progressed fast and she was constantly under scanner for fetal heart rate and maternal condition.

Supporting her birth was no easy feat because of the complications such as fever, and later meconium stained liquor. But her strong resolve and immense faith in herself along with the added support from our team ensured that she overcame all hurdles and gave birth to a healthy baby boy.

She enjoyed immediate skin-to-skin contact with her bundle of joy and we were able to witness a beautiful birth which despite being complicated was filled with love, trust, and mutual respect.

Benefits of VBAC:

The benefits of having a VBAC are similar to the ones you have with a normal birth. These include:

Short Hospital stay

If you have a VBAC, you’ll need to remain in the hospital for a shorter period of time as compared to the stay required after a C-section. It helps you get back on your feet almost immediately and carry on with your routine as usual.

Experience natural birth

It is important that you get to experience the feeling of giving birth nature’s way. It gives you a sense of empowerment and makes you feel more connected to your child. VBAC also has profound benefits for your baby. Some of these include, saving your baby from the harmful effects of epidural anaesthesia and better adaptation to breastfeeding.

Benefits for future pregnancies

Opting for a VBAC instead of a C-section in case of an uncomplicated pregnancy is advantageous for future pregnancies as well. This is because VBAC helps you avoid internal scarring that occurs when you undergo a C-section. It is also more likely that you will have a normal birthing experience in the pregnancy you have after a VBAC.

Lesser complications

VBAC or vaginal births in general are associated with lower rates of surgical complications such as excessive bleeding, infections, blood clotting, and injury to internal organs. It helps you recover faster post labour.

 

To all the women out there who fear having another child after a difficult C-section let Muqqadas’ story be the encouragement you need. We believe that nothing is impossible once you set your mind to it. Experiencing birthing in its true form is every woman’s right in uncomplicated pregnancies.

In Muqqadas’ own words, “
This has been an out of the world experience; I realized humanity does still exist. Empathy is still practiced in this time of selfishness. I am in a dream.”

 

 

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