Vbac (normal delivery after cesarean section): conditions to risk

Quite a number of mothers who want to try a normal delivery after a cesarean during a previous pregnancy for various reasons. Usually this is based on wanting to feel the "pleasure" of a normal birth pain at least once in a lifetime. In the medical world, the procedure for normal delivery after cesarean delivery is VBAC (vaginal birth after caesarean).

Some women may have the opportunity to give birth normally smoothly after having had a cesarean section.

However, it may be a different story for others because VBAC is a birthing process that cannot be done by just anyone.

What is VBAC?

VBAC is a term used to describe the normal delivery process after having had a cesarean section orc-section.

So far, a mother who has given a cesarean section will be encouraged to do another cesarean section in her next pregnancy.

The American College of Obstetricians and Gynecologists (ACOG) reveals that it is actually okay and possible for a mother to want to undergo VBAC.

VBAC is a safe delivery procedure to do as long as pregnant women meet the requirements and have a doctor's approval.

If you are interested, before approaching the day of delivery, it is better to first consider the benefits and risks of this VBAC procedure.

However, don't forget to provide various labor preparations and delivery supplies since the third trimester of pregnancy.

This VBAC procedure can be done when a pregnant woman gives birth in the hospital.

Meanwhile, if the mother wants to give birth at home with this procedure, you should further consult with your doctor.

Things to know before doing VBAC

As mentioned earlier, VBAC is a procedure that needs careful consideration.

It is true that a normal delivery procedure cannot be done by every pregnant woman who has had a cesarean section because it requires various considerations.

Various conditions that allow mothers to do and not do VBAC or give birth normally after cesarean are as follows:

Who can do VBAC?

The condition of pregnant women allowed normal delivery after cesarean delivery or VBAC are as follows:

Mothers who have a caesarean section in the form of a horizontal line that is located low under the stomach.
Currently carrying 1 baby, and only had 1 caesarean section before but not with a vertical incision.
Are pregnant with twins and had a previous cesarean section but not with a vertical incision.
Labor occurs spontaneously after induction, so contractions are fast.
Your pelvis is large enough to allow the baby to pass easily. Usually a doctor can determine this.
Have never done heavy surgery on the uterus, such as myomectomy to remove benign uterine tumors (fibroids).
Have never had a uterine tear in a previous pregnancy.
Do not have any medical conditions that make vaginal delivery a risk, such as placenta previa or fibroids.

Who is not recommended to do VBAC?

The condition of pregnant women not allowed normal delivery after cesarean delivery or VBAC are as follows:

Have had a cesarean delivery with a vertical uterine incision.
A vertical incision in the top of the uterus or a classic T-shaped incision will put you at a higher risk of developing a uterine rupture (uterine tear) upon later straining.
Have had a cesarean delivery with an unknown type of uterine incision, but it is suspected that it is a vertical incision (classic).
Have had a uterine tear in a previous pregnancy.
Have had severe surgery on the uterus before, such as removing benign uterine tumors.
Pregnant at a very old age.
Pregnant with excess body weight.
Babies born weighing more than 4,000 grams (gr), aka macrosomic babies.
Gestational age is more than 40 weeks.
The gestational age is too short, about less than 18 weeks.
Are pregnant with triplets or more.

Some hospitals or maternity clinics usually discourage mothers from undergoing VBAC if they have given more than two cesarean sections.

Also, consult your doctor if the mother is pregnant with twins and wants to give birth to twins with the VBAC procedure.

Benefits of VBAC

VBAC is a safe delivery procedure with a high success rate when performed properly.

Normal delivery after cesarean delivery also has the potential to bring a number of benefits to both mother and baby, such as:

1. Faster recovery process

Compared to giving a cesarean delivery, vaginal delivery requires a shorter recovery time.

This means that the time that the mother spends in the hospital will not be too long.

Mother can immediately return to other daily activities as before.

2. Involves a greater sense of "struggle"

A caesarean section involves administering anesthetic or anesthesia to reduce pain.

That's why the effort you put into getting the baby out of the stomach is usually not as big as a normal birthing process.

Conversely, vaginal delivery requires you to apply as much as you can during labor to push the baby out.

As a result, there is a distinct feeling of emotion after going through a long childbirth process.

Even so, the procedure for normal childbirth and this caesarean section will still provide priceless happiness.

Also make it a habit to practice breathing techniques during childbirth since pregnancy, for example through prenatal yoga exercises.

Mothers can also learn various labor positions in order to facilitate the process of a normal delivery after cesarean section (VBAC) later.

3. Reducing the risk of surgical complications

Basically, all types of surgery run the risk of causing complications during or after the process, as well as a cesarean delivery.

A caesarean delivery that does not go smoothly can increase the risk of serious labor complications.

The decision to give birth normally after cesarean section or VBAC can help reduce the risk of bleeding, infection, blood clots, or organ injury during labor.

When the signs of childbirth are visible but there has not been an opening, the doctor may give the mother an induction of labor.

Other signs of childbirth also include original labor contractions and broken membranes.

Meanwhile, if the normal delivery process experiences obstacles, medical procedures such as the use of forceps, vacuum extraction, to episiotomy (vaginal scissors) will be considered.

4. Reducing the risk of bad effects in the next pregnancy

Having had a cesarean section once or more will further increase the risk of potential health problems in future pregnancies.

For those of you who have planned to have many children from the start, VBAC is the right procedure because it helps prevent the negative risks of a cesarean delivery procedure.

The negative risks include uterine rupture due to injury and placenta problems due to cesarean section.

What's more, the risk of these complications will usually increase the more often you have a caesarean section.

Health risks of VBAC

Apart from the various good benefits that can be obtained through the VBAC delivery procedure, of course there are still disadvantages of normal delivery after cesarean delivery that must be considered.

The worst possible outcome of VBAC is failure because it does not complete a normal delivery.

This condition can make the uterus tear because the incision scar from a previous caesarean section opens, citing the American Pregnancy Association.

If you have this, an emergency caesarean section must be done immediately to prevent complications of childbirth, which include heavy bleeding, infection, and defects in the baby.

In some cases of severe bleeding, surgery to remove the uterus (hysterectomy) may be performed.

This means that you may not be able to get pregnant again if you have a hysterectomy.

Essential preparation ahead of VBAC

The most important step you should take before deciding to give birth to VBAC is to talk to your doctor.

During the consultation the doctor will review all of your medical history regarding previous pregnancy and childbirth.

If it is possible, your doctor can give you the green light for the VBAC procedure.

In addition, some preparations related to the procedure for normal delivery after cesarean delivery or VBAC are:

Learn all about VBAC.
Make sure you choose a health service or a hospital with complete delivery facilities, including for handling emergency caesarean section.
Prepare for the worst, for example, when complications suddenly occur while having a normal delivery.

Mothers can also attend childbirth classes which also discuss normal delivery procedures after cesarean delivery or VBAC.

We recommend that you get to know more about this birthing procedure before deciding to undergo it and ask your gynecologist's opinion.