What are the pros and cons of VBAC (vaginal birth after cesarean) ?

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Answered by: Beth, An Expert in the Birthing and Baby Care Category
There are a variety of pros and cons when considering a VBAC (vaginal birth after cesarean). First of all, you need to discuss this topic with your obstetrician and get his or her opinion. Using the internet to do research and seek opinions is ok, but it should not be your only form of information. Your medical provider who is guiding your pregnancy care should be involved in the birthing discussion.

Doctors are very helpful when they are asked direct questions. So, make a list and have it ready to ask your provider. A lot of consideration has to do with whether this is your 2nd or 3rd pregnancy. If it is your 3rd pregnancy and you have had 2 c-sections prior, the answer for having a vaginal delivery is most likely going to be NO. Your uterine wall has been cut twice during your last 2 surgeries, which puts you at a critical risk for uterine abruption. If this is your 2nd pregnancy and you have had a previous c-section without complications, and your current pregnancy is without complications, you might be a likely candidate for VBAC (vaginal birth after cesarean) procedure.

One of the most positive pros to a VBAC after only 1 c-section is that you are experiencing a new birthing process. This is a new experience with a new child, something that both of you will share together forever. Another one of the pros of a VBAC is that you are not undergoing another abdominal surgery with additional recovery time. Having a baby by c-section is a double-whammy --- you are involved in two processes: surgery and having a baby.

Vaginal deliveries for the most part are uncomplicated and natural for the female body; meaning that recovery time is much more succinct. Yet another pro to VBAC is the body is given far less numbing medication (anesthesia). Anesthesia is a difficult chemistry for the body to metabolize and can sometimes cause complications. Some of the cons to a VBAC are that you are putting your uterus at unknown risk. This is a very serious situation to consider for both you and your unborn child. Your OBGYN (if it is the same care provider from your 1st delivery) will make notations in your medical chart regarding the thickness and strength of your uterine wall.

If it is "thick" and not "thin" you are in a better place to go towards the VBAC. If your uterine wall is considered "thin" during your 1st c-section, your OBGYN is going to recommend that you opt for the 2nd c-section. OBGYNs for the most part believe that if you have had 1 c-section, that it is better to go ahead and have another c-section. They do not want their patients to undergo any unnecessary risks and a VBAC can bring lots of unknowns at a time when it is best to know what is going on.

The bottom line is that the patient and the OBGYN need to be on the same page and both feel comfortable about the delivery procedure. This is a situation that warrants discussion and consideration, with proper thought placed on the health and safety of mother and child.

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