Yahoo Lifestyle Preparing For a VBAC
In the battle to reduce the rising rate of caesareans, health experts say that increasing the number of women having vaginal births after caesareans (VBACs) is critical.
Research shows that, for most women, VBAC is a safe option and success rates are pretty good, with 60 to 80 per cent of Australian ladies attempting a VBAC being successful. That being said, currently only a small percentage of women actually try for VBACs. On the whole, just 17 per cent of mums give birth vaginally after previous caesareans.
What happened during your first caesarean?
Knowing exactly what happened during your first caesarean is the first step in making an informed decision about trying for a VBAC. (Ideally this information should be given both verbally and in writing to you and your GP.) Having this discussion with an experienced midwife or doctor is important, as there are some things that can happen during a caesarean that make going down the vaginal-birth route with a subsequent bub unadvisable.
Advantages of a VBAC
There are many advantages to having a VBAC. Usually after a vaginal birth, women are up and about straight away and able to care for a bub without the need for pain relief. A caesarean is a major operation that requires a number of days – sometimes weeks – to recover from and requires pain medication for some time. In the early days, activity is restricted and this can make caring for a baby more difficult, especially when there are other young kids in the mix.
The time after birth is also important for bonding, and after a caesarean the baby is taken to the postnatal ward whilst mum is stitched up and taken to recovery. After a vaginal birth, providing both mother and baby are okay, they are not separated.
For many women, too, experiencing a vaginal birth is an important and empowering experience. If your first caesarean has undermined your confidence in your body, then a VBAC can be very healing. There is also the cost factor to consider, with a caesarean costing the health system double that of a vaginal birth.
Medical advice and support
The rate of successful VBACs in Australia is not as high as in other countries, so once the decision to try for a VBAC has been made, it’s important for you and your partner to have good support and advice at hand. Choosing a sympathetic caregiver who you trust and who is experienced with VBACs is therefore essential.
The next decision to make is where you’ll give birth. Some hospitals aren’t as good as others in supporting the VBAC route, so ask about the caesarean and VBAC rates at your chosen venue. Some hospitals supply specific VBAC information for women, which is a good sign they are supportive.
One-to-one care with your own midwife is ideal for a VBAC and many hospitals now offer this. Alternatively, you can pay for your own private midwife or a doula.
During labour it’s important that interventions are kept to a minimum to increase the success of a VBAC. Induction of labour is not recommended for a VBAC prior to 42 weeks, as the induction process may put extra stress on the uterus. It’s also important for you to feel like you have enough time and aren’t being pressured to labour according to the hospital’s time restrictions.
Weighing up the risks
As with any birth, there are risks with VBACs. When you’ve had a previous caesarean, the main risk everyone talks about is your uterus rupturing (opening along the old scar line) – but the chance of this happening is less than one per cent. Overall, complications for caesarean births are higher (up to 28 per cent) than for vaginal births (up to three per cent).
It’s always wise when planning for a VBAC to prepare for the possibility of having another caesarean. Your labour will be monitored closely and if progress seems to be slow or if your baby’s heartbeat is abnormal, then a surgical birth will probably be recommended.
If you do end up having to have another caesarean, still be proud of yourself and the effort you have made. No matter how the birth goes, it is still the birth of a baby and that is the miracle!
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