To VBAC or not to VBAC?

There’s been lots of VBAC discussion on our Instagram feed over the past couple of days. I wanted to have a greater handle on the recent facts and stats, so I was read an article on The Conversation by Hannah Dahlen last night on vaginal births after caesarean sections (VBAC) (read it here).

With nearly one in three women in Australia giving birth via caesarean, I feel like I am only really just now starting to hear more and more about VBAC’s. Yes, as Midwives we are taught and study this but anecdotally I hadn’t come in contact with many women asking for a VBAC, but more so of midwives asking women if they knew about a VBAC being an option and did they want to consider it.
It’s lovely to hear more women, through the channels and power of social media discussing topics like this, sharing birth stories and channelling positive empowering pregnancy energy.

It is important to mention that “most Australian women (84.4%) have a caesarean for subsequent births after a caesarean. Only 15.5% of women have a VBAC. In private hospitals, this rate is even lower, at 11% “(Hannah Dahlen)… however of the women that do attempt a VBAC, 70% of these women are successful in giving birth vaginally and do not need a repeat caesarean section. Which is nothing to sneeze at, right?

Yes, a repeat caesarean section is a decision that is solely that of the couple after an informed conversation with their health practitioner, and fabulous advancements in research now mean that babies are not separated from their mamas (health of mum and bub permitting) and there are things like seeding available for women (vaginal microbes wiped onto babies as they are born via caesarean so to simulate as best possible the antimicrobial goodness bubs receive from the birth canal) and skin-to-skin and breastfeeding support happening in theatres and recovery; facilitating the mother-infant dyad.

But if you’re a low risk, healthy mama, and want the option of a VBAC, and want to know more, continue reading!
It’s a conversation worth having antenatally with your midwife or obstetrician!

Benefits of a VBAC?

  • Greater chance of uncomplicated births in the future
  • Recovery is a lot quicker – due to no abdominal surgery
  • Reduced risk of blot clots
  • Skin-to-skin, mother-infant bonding, breastfeeding etc. may be established quicker.
  • Shorter stay in hospital

Risks of a VBAC?

  •  uterine rupture may occur. Statistics are about 1 in 200 VBAC’s there will be a uterine rupture (the scale of which varies drastically from slight rupture to the uterus opening up completely…which is very much cause for concern and can have dire outcomes).
  • “In terms of the baby’s safety, guidelines on VBAC just released by the United Kingdom’s Royal College of Obstetricians and Gynaecologists (RCOG) state that the risk of a baby dying during labour and birth is extremely low and is similar to the risk for women having their first baby”(Hannah Dahlen).

Do VBAC outcomes differ based on hospital setting?

Some hospitals in Australia offer VBAC programs for mothers that have had 1 caesarean section…other hospitals have programs that offer women the option of a VBAC after 2 caesarean sections.

Does a VBAC mean I have to labour differently?

Continuous cardiotocograph monitoring (CTG) may be implemented to keep a close eye of the wellbeing of bub. Protocols may vary from hospital, state, obstetrician etc., so this is a good question to ask your midwife of doctor so you know what to expect.

So if you’ve had a previous caesarean section and are unsure as to your personal situation and your options, asking lots of questions to you midwife or obstetrician,  and regardless of whether you choose to try for a VBAC or choose an elective caesarean, just asking questions helps to make informed decisions.

Image via Hannah Tallo of a VBAC mama
Resource: hyperlinked article (first paragraph) The Conversation, Hannah Dahlen

 

 

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