Vaginal Birth After Caesarean Section (VBAC)
Many women do not want to have another caesarean section and having a VBAC is a very safe choice to make. For many women it is not just about physical safety but is an emotional, social and psychological choice too.
Despite the reason for the previous caesarean section many woman want to be able to experience vaginal birth. Very often there are feelings of guilt that their bodies may have failed them and the need to give birth vaginally can become overwhelming.
When making the decision about choosing VBAC or repeat caesarean section, women should be told about the risks involved with both. The evidence from research confirms the safety of VBAC in that it is associated with lower risk of many complications for both mother and baby than a repeat caesarean. Complications such as operative injury, infection, bleeding, post natal pain and effects on future fertility. Vaginal birth however has the risk of scar rupture which although very low can be very serious for mother and baby.
Most scar ruptures are 'silent' or 'incomplete' - the scar stretches and thins but this does not harm mother or baby at all. Research has shown that the generally accepted risk of all scar ruptures is 0.5% or 1 in 200 births. It is very rare for a life- threatening complete rupture of the uterus to occur and the incidence is 0.09% - 0.8%. To put this into perspective, any labouring woman is about 30 times more likely to need an emergency caesarean section for another serious complication like a haemorrhage for example, than a woman needing one because of a complete scar rupture.
We actively support women having VBAC as long as it is a fully informed choice. At Kent Midwifery practice we have cared for women who have had more than one previous caesarean and achieved a vaginal birth. Most women have given birth at home; some have chosen water births. About 80% of our client achieves the VBAC they desired.
You may want to read the following book available from Amazon: Vaginal Birth After Caesarean: The VBAC Handbook by Helen Churchill and Wendy Savage April 2010