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Vaginal Birth after Cesarean - Know the Facts!

Written and reviewed by
FRCOG (LONDON) (Fellow of Royal College of Obstetricians and Gynaecologists), Certificate of Completion of Training (CCT) - Nephrology, MD - Obstetrtics & Gynaecology, DNB, MBBS
IVF Specialist, Chennai  •  26 years experience
Vaginal Birth after Cesarean - Know the Facts!

It is a common notion that once a woman undergoes a Cesarean section, subsequent deliveries will have to be done by C-section too. This is not true and vaginal birth after cesarean is a very normal occurrence.
There are good chances that a woman can have normal vaginal delivery after a cesarean. However, this needs to be planned and the doctor and the mother would need to be prepared for it. There is also a good chance that the vaginal delivery may eventually be converted to a Cesarean, and so the doctor should be prepared for it too, parallely. This is known as TOLAC (trial of labor after Cesarean). The doctor will attempt for a vaginal delivery, but if it does not succeed, then Cesarean will be undertaken. This is an extremely safe procedure, though chances of success vary from one person to the other.

If you are keen on a vaginal delivery after a C-section, talk to your doctor to understand the risks and what to expect, both before, during, and after VBAC.

Benefits:

  1. Both the baby and the mother have great benefits to see, if opting for a VBAC. Some of them include:
  2. Reduced risk of maternal mortality with VBAC as compared to repeat Cesarean
  3. Less pain after delivery
  4. No uterine incision (The more number of deliveries, the more incisions)
  5. Less chance of infection as another incision means another chances of infection, hemorrhage, sepsis, etc.
  6. Reduced anesthetic complications and need for blood transfusion
  7. Reduced chances of internal organ damage, bladder injury, uterine perforation, etc.
  8. Reduced hospital stay and faster recovery from vaginal birth
  9. Reduced scar management
  10. Reduced chances of maternal morbidity
  11. Better immune response and protection against diseases like asthma, obesity, etc. for the child

Risks of TOLAC/VBAC:

  1. Good chance that an attempted vaginal delivery could get converted to a cesarean section
  2. Possibility of the previous Cesarean incision tearing open, which would immediately call for conversion to a Cesarean section

The trend for most doctors is to advise for a Cesarean section, if the previous delivery was through Cesarean. However, this need not be the case. Mothers are advised to look for hospitals, which have a low rate of C-sections and encourage vaginal delivery. The success rate of VBAC is about 60% to 80%, and should be encouraged. It is completely safe and preferable to have vaginal delivery, unless totally contraindicated. A prior cesarean alone should not be the reason to opt for a C-section. Have a detailed discussion with the doctor and go for a TOLAC. If it does not succeed, for whatever reasons, it can always be converted to a Cesarean section.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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