Giving Birth After You Have Had a Cesarean

If you have already had a cesarean and are now pregnant again, you may be interested in asking the doctor if you can have a vaginal birth or if you will have to have a cesarean again. This term is in fact called Vaginal Birth After Cesarean and it is what VBAC stands for. It is a vaginal birth after a woman has had one or more cesareans. More than 80% of women are able to and capable of having a VBAC. 

There are many reasons why some women are interested in having a vaginal birth after a cesarean. In some cases the reasons may be medical and in some they may be emotional. There are also others that look at the financial aspect and others that look at the aspect of recovery. Whether or not a woman is able to have a vaginal birth after cesarean largely depends on the type of cesarean she had:

• Low transverse cesarean. Almost all cesareans are done through a low transverse incision these days. Women that have had this type of incision can generally have a vaginal delivery in other pregnancies as long as no other additional complications arise.

• Classical cesarean. If you have had a vertical incision in the top part of the uterus you should not try to have a vaginal delivery in later on pregnancies because this type of incision has more probabilities of breaking. Vertical incisions are sometimes done in cases of preterm labor or placenta previa, or when the uterus of the mother has an abnormal shape to it or big fibromas.

• Low vertical. Low vertical cesareans are not done is frequently as the low transverse ones, however they do allow for the mother to have a vaginal delivery in posterior pregnancies.

The incision that was done in the skin does not reflect the type of incision that was done in the uterus. This means that it is possible to have a transversal incision in the skin and a vertical incision in the uterus.

Doctors were once under the impression that after a woman had had a cesarean that she would always have to give birth this way, and that trying to allow the woman to have a VBAC would rupture the uterus because of the scar of the cesarean. However there are studies that demonstrate that this rupture is unlikely and that there is a very minor risk in it. And yet other studies have shown that around seventy percent of women have been able to have a VBAC without any problems. Obviously being able to achieve this depends on the reason the cesarean was done in the first place. If the doctor performed a cesarean because the baby was in a podalic position the chances of the next delivery being able to be a vaginal delivery are around ninety percent. If the cesarean was done because the baby was too big for the mother’s pelvis the chances go down to fifty to sixty percent.

Some of the reasons a woman would want to have a vaginal birth are as follows:

• There is less risk of death from surgery

• The amount of complications that surgery entails reduce 

• Less blood loss

• An infection is less likely

• Less chances of injuries in adjacent organs

• Blood clots will not accumulate in the legs

• Breastfeeding is usually less complicated 

• A vaginal birth is cheaper

• Recovery time is easier

There are certain risks to doing this though, which are that if having a vaginal birth after having had a cesarean does not go about successfully, the recovery time can take longer than if you had chosen to get a cesarean.