After a C-Section, Vaginal Birth May Still Be an Option

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Often things can be outside of your control. If your first birth was a C-section, there are many reasons behind it. Perhaps you thought any future deliveries would have to be C-sections as well.

While that was close to the truth , things are changing.

In recent years, medical restrictions on giving birth vaginally after a C-section have eased. AdventHealth is invested in supporting women who want to attempt a vaginal delivery for their next child. By giving pregnant women the facts and allowing them to decide what's best for their delivery, vaginal delivery is an option once again.

It’s called a “trial of labor,” and it’s a “safe and suitable choice for most women who have had a prior cesarean delivery,” according to the American Congress of Obstetricians and Gynecologists.

Some hospitals and doctors do not accommodate trials of labor, due in part to the need to have an obstetrician available at all times. At AdventHealth, obstetricians are always available so that surgical delivery is not your only option.

Each mother’s story of labor and delivery is different, and the journey of birth is ultimately a personal one. Our goal is to give you the information and support to make the informed choice that’s right for you and your baby.

Who is VBAC for?

Many women can choose to attempt a vaginal birth after a C-section, or VBAC, for their next pregnancy. A discussion with your doctor is the best way to learn whether you qualify, but women who are the best candidates for a successful VBAC generally:

  • Have had no more than 1 to 2 previous C-sections
  • Had a prior successful vaginal delivery after a C-section
  • Had the most common type of incision used for prior C-section which is called a low transverse incision

Each woman’s situation — her medical history, personal risk factors and goals for delivery — is different, so a discussion with your doctor is the best way to determine if you’re a good fit for a trial of labor.

It’s also important to note that a trial of labor is not a guarantee labor will proceed naturally. Nationwide, between 60 percent and 80 percent of women who attempt a trial of labor will achieve a natural birth.

Those odds don’t necessarily hold for each patient, though. Depending on your circumstances, your attempt at a VBAC may be more or less likely to be successful, and that may weigh in to your decision to attempt a trial of labor.

Why consider VBAC?

While women typically have a choice about how they deliver, there are advantages to vaginal delivery. These include:

  • Shortened recovery after birth
  • Reduced risks that come with major surgery, like heavy blood loss or infection
  • Decreased risk of requiring a hysterectomy

That said, there are risks of attempting a VBAC.

The greatest risk of a vaginal birth after a C-section is the higher risk of a rupture of the uterus, usually at the site of the scar from a previous C-section. This is a serious complication, and a major reason home birth is not recommended for women who’ve already given birth by C-section.

But even the heightened risk of uterine rupture is still low, occurring in less than 1 in 100 women who undergo a trial of labor. This risk can differ based on a woman’s prior obstetric history, so you should ask how these risks apply in your case. Finally, at AdventHealth, the clinical team closely monitors for signs of a uterine rupture. Doctors are always on hand to respond in the unlikely event one occurs.

Many physicians believe each woman should be able to decide which delivery method is best for her based on discussions she has with her healthcare provider. Understanding the immediate and long-term risks and benefits both to her and her baby is critical to decision-making.

It's important for expectant mothers to feel involved in and in charge of their labor story.

Mothers can always change their mind. These discussions are best had in the months before delivery, as goals can change as the anticipated date nears. Exercising choice through decision making leads to improved health and longevity and helps strengthen investment into patients' personal health journeys.

Thanks to our deep pool of expertise, we’re ready to adapt if plans change and it becomes necessary to perform a C-section. Our goal is for mothers to be confident about their choice, because, in the birthing room as elsewhere, a positive attitude can strengthen the health of your mind, body and spirit.

Learn more about AdventHealth's women care services here.

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