The best for baby and you

While many do opt for a C section, whether or not or medical advice, vaginal birth after caesarean or VBAC as it’s known for short, allows a woman to give birth safely and comfortably, even if an earlier pregnancy resulted in a C-section. The American College of Obstetricians and Gynaecologists recommends that all doctors offer VBAC to expectant mothers. 

Anyone who wants a natural birth is an ideal candidate for VBAC though it should be noted that it’s not entirely without risk: there is a 1 per cent or lower risk of uterine rupture.

To assess the risks associated with VBAC, it is helpful to determine why a previous pregnancy might have resulted in a C-section. For example, if the abnormal position of the baby or the abnormal location of the placenta necessitated the first caesarean, VBAC would be a low risk process the next time. However, if a C-section was required because of the mother’s small pelvis or the baby’s large size, vaginal birth could be complicated for subsequent pregnancies as well. Risks associated with VBAC increase if a woman has had uterine surgery, more than one C-section, or if her baby is bigger than her pelvis. If the interval between pregnancies is less than a year, risks increase substantially; some doctors are unwilling to recommend VBAC to such patients. 

In all other cases, VBAC is highly recommended as it saves mothers and infants from the many risks associated with a C-section such as higher rate of infection, higher adhesions and abnormal placenta, which can cause heavy bleeding and eventually lead to a hysterectomy. With a C-section, the number of children a woman can have is limited. However, once a woman reverts to vaginal birth, she can have as many babies as she wants.

Mothers who are keen on VBAC must try to ensure that their baby is not very large, but is extremely healthy. This is easily achieved by following a healthy diet high in proteins, minerals and vitamins and low in carbohydrates and fats. Such a diet not only ensures the baby’s growth, but also good health. Food high in fat and/or carbohydrates can make the baby large.

Women who you have had a C-section earlier and would now like to have a natural birth, need not worry. They should plan their pregnancy and delivery the way they plan meals or their career – step by step. Once the plan is ready, implement it diligently. Many factors have to be taken into consideration, the most important of which are the health of the mother and child.

VBAC is only risky if the woman has had a C-section recently, less than a year ago, expecting a multiple birth, has a very small pelvis and a very large baby or suffers from any other infections/complications.

VBAC should be chosen in a woman wants have more children in future, wants to reduce the amount of medicines she and her infant are exposed to and wants to form a close bond with her newborn in the golden hour.

 

 

 

Dr Yaowaluk Rapeepattana is an obstetrician-gynaecologist Samitivej Sukhumvit Hospital. For more information, contact the Women’s Health Centre at (02) 711 8555-6.