Introduction
It is possible to have the next child vaginally if the patient has already had a cesarean (also known as C-section) birth. A vaginal birth after cesarean (likewise called VBAC). Cesarean birth is a medical procedure where the child is brought into the world through a cut that a healthcare professional makes in the stomach and uterus.
The majority of women who try VBAC are successful in having a baby through the vaginal route. Communicate with the healthcare professional from the start of the pregnancy to see whether VBAC might be a decent decision for the mother as well as the child.
How Does a C-Section Work?
A C-section (cesarean birth) is a medical procedure where the child is brought into the world through a cut that the healthcare professional makes in the tummy and uterus. They may need a C-section to protect the baby's health if they have medical conditions that affect the pregnancy.
A C-section might be arranged (likewise called planned). This implies the healthcare professional chooses when to plan the c-area in view of the ailment and the state of the child. A C-section may also be necessary in an emergency because the health of the mother or the health of the baby is in danger, an emergency C-section must be performed right away.
Talk to the physician about delaying the C-section until at least 39 weeks of pregnancy if there are medical reasons to do so. This gives the child the time she/he really wants to develop and nurture before birth. Planning a C-section should only be for clinical or medical reasons only.
What Are the Clinical and Medical Complications Behind a C-Section?
The mother might require a C-section due to inconveniences that make vaginal birth dangerous for her or the child. For instance:
Consequences of Pregnancy:
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Past record of C-section or any other surgery. It runs a greater chance of having problems during pregnancy if the patient has more C-sections. A few ladies can securely have a vaginal birth after they have had a C-section. In the event of a C-section previously, communicate with the medical supplier to check whether VBAC might be conceivable in the next pregnancy or not.
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During vaginal birth, there are issues with the placenta, such as placenta previa (when the placenta covers the opening in the cervix), that can result in potentially fatal bleeding. The placenta feeds in the uterus and supplies the child with food and oxygen through the umbilical cord.
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Presence of a disease similar to HIV or genital herpes. During vaginal birth, transmission of these infections to the baby is possible. Therefore, a C-section is safer for the baby.
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Presence of an ailment or medical condition that might make vaginal birth dangerous, similar to diabetes or hypertension. Blood vessels and nerves, among other organs in the body, could be harmed by this. Hypertension is the point at which the force of blood against the walls of the veins is excessively high. It can pressure the heart and create issues during pregnancy.
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Previous delivery of more than one child—twins, triplets, or more.
How Can One Determine Whether Having a VBAC Is Ideal for the Patient?
While considering a VBAC, consult the physician to weigh the benefits and risks in order to decide whether the chances of VBAC success are high or low.
Conditions having a better chance of having a successful VBAC:
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Vaginal birth previously.
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Have had only one C-section previously with a low transverse incision, also known as a bikini cut.
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This indicates that the cut was low on the uterus and horizontal (side to side). The most prevalent type of C-section incision is this one. Compared to other incisions, it typically bleeds less. Additionally, it strengthens the uterine scar, making it less likely to tear.
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The pregnancy is a healthy one for both the mother and the unborn child.
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The labor begins independently just before or on the day of the due date.
The chances of getting a successful VBAC are lower if:
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Pregnancy with the same condition that required a C-section during the previous pregnancy. For instance, the baby's heart rate is irregular, or he is lying on his side in the womb.
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Induced labor past due date.
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Obesity during pregnancy.
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Pre-eclampsia: This condition can occur either immediately following pregnancy or after the 20th week. It occurs when a pregnant woman has high blood pressure and indications that some of her organs, such as her liver and kidneys, may not be functioning properly, resulting in the presence of protein in the urine, changes in vision, and serious migraines.
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A short interpregnancy interval is when there are fewer than 18 months between the past and the current pregnancy.
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The child is exceptionally huge.
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If the delivery center is not prepared to handle an emergency C-section.
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Age above 35 years old or of a race other than white.
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A few suppliers may not offer VBAC in the event that the patient has had multiple previous C-sections or, on the other hand, assuming the pregnancy carries triplets or a bigger number of offspring.
It is unsecured to have a VBAC if:
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The entry point during the previous C-section was not low transverse but high vertical. A uterine rupture (a tear in the uterine muscle) may become a complication in this case.
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The complication of uterine rupture in the last pregnancy. During labor, this occurs when the uterus (womb) tears.
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Particular sorts of medical procedures/surgeries are performed on the uterus.
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The presence of certain health issues or pregnancy complications, like diabetes, heart disease, genital herpes, or placenta previa, indicates a C-section.
What Are the Advantages of Having a VBAC?
Having a VBAC has a few advantages, including:
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Surgery is not required.
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The recovery rate is faster than a C-section.
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Less blood is lost.
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Lower chances for disease/infection and different complexities, similar to issues with the placenta.
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There is a lower chance of complications from multiple deliveries, such as scarring or injuries to the bowel or bladder, if the intention is to have a lot of children.
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A vaginal birth might be something a mother wants to experience.
What Are the Dangers of Having a VBAC?
Even if the mother and the baby are healthy during pregnancy, a VBAC can have some risks. These dangers include:
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Unsuccessful labor indicates a C-section anyway.
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An infection, injury, and loss of blood
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A tear in the uterus, although uncommon, could be fatal.
How to Anticipate a VBAC?
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In the event of a recent C-section and pregnancy, communicate with the physician about VBAC at the latest pre-birth visit.
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Enroll in a VBAC class.
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Be prepared and aware that complications may require a C-section at times. Inquire as to whether the medical facility for delivery has what it needs if there should arise any crisis during a C-section. For VBAC, a home birth is inappropriate. A hospital should be used for VBAC.
Conclusion:
In the end, it all comes down to how much risk patients, hospitals, and doctors are willing to take. However, the efforts of all three will be required to reduce the number of C-sections.
It is a social responsibility to identify the numerous factors and make adjustments that are safe for mothers and babies. The doctors, women, midwives, policymakers, lawyers, and risk managers must all collaborate on this issue to educate and make future mothers and make it clinically possible.
