Pregnancy and Trying to conceive

Is Vaginal Birth Possible after a Caesarean Delivery?

Written by
Dr. Sabita Laskar
and medically reviewed by iCliniq medical review team.

Published on Jul 04, 2014 and last reviewed on Sep 07, 2018   -  3 min read

Abstract

Abstract

In the earlier days the norm was 'once a caesarean, then always a caesarean'. Nowadays it has changed quite a lot due to advances in medical sciences, and also due to the awareness of the advantages of normal delivery over caesarean.

Is Vaginal Birth Possible after a Caesarean Delivery?

There are few factors on which a successful vaginal birth following a Caesarean delivery (C-section) depends.

Your chances for a normal delivery are good if:

  • You have already had only one C-section.
  • You have had a normal delivery after a C-section.
  • Yours is an uncomplicated pregnancy with a normal healthy baby.
  • You have spontaneous onset of labour pain.
  • The reasons for which you had a C-section are not repeating this time.

Your chances for a normal delivery are less if you have the following:

  • If the interval between your C-section and next pregnancy is less than 3 years it is very unlikely that you will be offered normal delivery.
  • If you have already had more than one C-section, with no normal deliveries in between.
  • If you have crossed your due date.

VBAC (Vaginal Birth After Caesarean) is absolutely contraindicated:

  • If you have had a classical C-section, where you have a vertical incision on your uterus.
  • If you have had more than two C-sections with no normal deliveries in between.
  • If you have had uterine rupture before.
  • If you have had uterine myomectomy (surgical removal of myomas in the uterine cavity).
  • If you have had prior hysterotomy (a form of abortion in which the fetus is surgically removed just like in C-section through an abdominal incision).
  • If you have had complicated pregnancy like placenta previa (a pregnancy problem in which the placenta covers the opening of the cervix).

Benefits of VBAC:

A vaginal birth following a C-section opens the door for you for future normal deliveries, specially when you plan to have a big family.

  • Shorter hospital stay.
  • Early mobilization - in a few hours you are ready to move about.
  • Less post operative pain.
  • No anaesthetic complication.
  • No major surgical complication.
  • Less respiratory complications for your baby.
  • Increases chances for you to have normal deliveries in future.

Risks of VBAC:

  • Repeat C-section - many a times labour needs to be terminated in a C-section. The reason could range from impending rupture of uterus, fetal distress and shoulder dystocia (condition in which one of the shoulders of the baby gets stuck behind the pubic bone during labour).
  • Increases chances of infection - a trial of labour that ends up in a C-section increases the risk of infection to your uterus as well as the abdominal wall.
  • Increases chances of surgical complication - injury to nearby organs.
  • Uterine rupture - your uterus might open up along the line where your previous incision was done. If this happens during labour or before labour you need to have an emergency C-section.

How to prepare for a successful VBAC?

  • Make yourself well prepared by learning about VBAC.
  • Gather as much information about it as you can.
  • Talk to your doctor. Understand your chances.
  • Take good care of yourself and your baby.
  • Choose a well equipped hospital.
  • Prepare yourself mentally for a C-section if an emergency arises.

VBAC must be tried in a centre with:

  • Neonatal ICU.
  • 24x7 emergency operation theatre.
  • Adult ICU.
  • Blood bank.

Your ultimate aim is to have a healthy baby and a healthy you, needless of the path which you take to get there.

Last reviewed at:
07 Sep 2018  -  3 min read

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