Pros and Cons of Vaginal Birth After C-Section
February 21, 2023
Women who have given birth via cesarean section (C-section) may wonder if it is possible to have a vaginal birth in the future. Joel Hallam, DO, a board-certified OB/GYN at Lakewood Ranch Medical Group, says that it can be done. The procedure is called vaginal birth after cesarean (VBAC).
“Some women may not have been given a chance to deliver vaginally due to breech presentation at term or another contraindication to vaginal delivery,” Dr. Hallam explains. “Other women would just prefer to avoid another surgery.”
Dr. Hallam prefers to give his previous C-section patients all available options for delivery. If a woman decides she would like to attempt a VBAC, he carefully reviews the patient's records to determine the indication for the prior C-section. “As long as there are not any contraindications to VBAC, we come up with a plan and discuss risks associated with the procedure,” he says.
Candidates for VBAC
There are several criteria that Dr. Hallam looks for to determine if a VBAC is right for a patient. If a patient had a previous C-section, the type of procedure matters. A low transverse C-section (LTCS) is one in which the lower, thinner portion of the uterus was incised.
“As long as a woman has had a previous LTCS, she is a candidate for VBAC,” Dr. Hallam explains. “However, there can be contraindications to VBAC even if you have a prior LTCS.”
In order to undergo VBAC, a woman also must have had no more than two previous C-sections and have no other scars on the uterus. In addition, there must be no history of:
- Uterine ruptures
- Placenta previa (placenta blocking the cervix opening)
- Accreta (placenta deeply attached to the uterine wall)
- Vasa previa (umbilical cord blood vessels across cervix opening)
- Any other contraindications to a vaginal delivery
Women must work closely with their OB/GYNs to determine whether VBAC is a good option for mom and baby.
VBAC Risks vs. Rewards
VBAC shares the common risks associated with vaginal birth, including hemorrhage, vaginal tearing and shoulder dystocia (when baby’s shoulders are stuck above mom’s pubic bone). There are also rarer risks such as uterine rupture, emergency C-section and maternal death.
With a more natural approach to childbirth, Dr. Hallam says, “the advantages for mom and baby may include shorter hospital stay, avoiding the risks that come with surgery and quicker return to daily routines. With the baby passing through the birth canal, it can get the natural squeeze of labor which decreases respiratory issues post-delivery.”
“VBACs are an individualized approach to delivery for both the patient and the physician,” says Dr. Hallam. “There needs to be good communication and understanding surrounding the risks, benefits and potential outcomes prior to ever agreeing to attempt a VBAC.”
Preparing for VBAC or Any Delivery
Dr. Hallam recommends that all women preparing for any type of delivery, especially VBAC, “put their body in the best mental and physical state as possible.” He adds, “incorporating alternative therapies is a good way to do this.”
Hypnobirthing can be practiced for the relaxation of mind and body. Pelvic floor therapy helps to strengthen the important muscles that support the uterus. Women may choose to see a chiropractor for adjustments that bring the spine and pelvis into alignment, which may make birth more comfortable.
If you or a loved one is considering vaginal birth after cesarean section (VBAC), consulting a qualified provider is crucial.