There’s no denying it. Cesarean births are on the rise. In 2018, 37 percent of babies born in private centres were delivered via c-section surgery. In some cases, the surgery was essential for the survival of the mother and baby. But in others, new mothers could be coerced by their obstetricians to undergo the more convenient method (for the doctors, not the mothers) of birthing. Many of these mothers felt cheated out of the experience of natural childbirth. When it’s time for baby number two, they are told, ‘once you’ve had a c-section, you can’t have a vaginal delivery’. It couldn’t be further from the truth. 60 to 80 percent of women who attempted a VBAC delivery were successful in their efforts. All it takes is a little preparation, education, and confidence.
What you should know about VBAC
Vaginal birth after a c-section (VBAC) can help you recover quicker and has a lower risk of complications that come with surgery. Your chances improve dramatically if you have had a risk-free, healthy pregnancy, a horizontal cesarean scar and only one prior c-section surgery.
However, if you have health issues, are overweight or past your due date, a VBAC might not be a feasible option. There are also fears of a uterine disruption that can occur during VBAC. While this is a serious complication where the c-section scar can rupture during birth, the odds of one happening are also quite low.
How to increase your chances of a VBAC
1. Educate yourself
Many women continue to believe the age-old fallacy that once you have a c-section, you will always have a c-section. There are even doctors who propagate this false theory. It’s best to speak to conscientious, well-informed obstetricians and medical professionals who have performed VBAC operations. It’s also advisable to speak to women who’ve undergone a vaginal birth after a prior cesarean about their first-hand experiences. The more you learn, the more you will know.
2. Keep an 18-month gap between delivery and conception
Most doctors advise their patients to roughly keep a 2-year gap between pregnancies. This helps your body recover properly. It also reduces the chances of a uterine rupture along with complications with the placenta. This time gap ensures your scar is fully healed and your body is ready to procreate again.
3. Have your next baby before 35 years of age
Age plays a big role here. Medical professionals believe that younger women tend to have more success during a VBAC attempt. Women 35 or over have lower chances to undergo natural labour due to the rising possibility of several health complications. However, most women in urban India who enjoy a healthy, stress-free pregnancy, it’s especially in urban India now opt to have a child even after 35 and are able to have a worry-free pregnancy with natural labour and delivery. So if you are over the age limit, but in good health, you can still discuss your options for a VBAC with your doctor.
4. Maintain your weight
A certain amount of weight gain is inevitable and essential during pregnancy; doctors advise women to avoid excessively piling on the kilos. Obesity during pregnancy can affect your baby’s position, which can, in turn, affect your chances of natural birth. Weight gain can bring other health issues which can hinder your ability to undergo a VBAC surgery. As appealing as junk food may be to a pregnant woman, stay away. Stick to a healthy, nutritious diet, even if it takes every ounce of your will power. Prenatal yoga, walking, and other light exercises can also help to keep your weight under control, increase your flexibility and keep your joints lubricated. This will come in handy when it’s time to push that baby out.
5. Manage your blood pressure
High blood pressure is a serious concern. If your numbers are above the normal limit (140/90 is considered normal during pregnancy), your doctor may be hesitant to try a VBAC. High BP can lead to a severe medical condition called preeclampsia, which can lead to several health issues for the mother like heart disease or organ failure (click on the link to read more about preeclampsia). In some cases, one may be required to induce labour or perform a c-section for the safety of the baby. While genetics can play a role in pregnancy-induced hypertension, you can do a few things to keep your BP in check. Limit your sodium intake and try to stay physically active. Also, avoid stress with relaxation methods like yogic breathing techniques and meditation.
6. Choose an experienced doctor
There are quite a few doctors who discourage patients from undergoing a VBAC. However, there are also a few who now understand the value of vaginal birth, and are equipped to handle them. Look for natural birthing centres that support VBACs. They are also able to prepare for an emergency C-section option, in case the need arises.
7. Allow natural labour
It is, in this case at least, best to let nature take its course and allow your body to go into labour. Inducing labour lowers your chances of a VBAC, as it could cause uterine rupture.
8. Check your ‘real’ due date
Most doctors advise against waiting till past your due date, especially for a VBAC. However, you need to make sure your due date is accurate. Get a second opinion with another doctor, so you know exactly how far along you are. And this also helps you to wait for the right time until you go into labour naturally.
Fear is a powerful thing. And when it comes to the welfare of your unborn baby, you don’t want to take any chances. However, vaginal birth after c-section delivery is not as risky as most people seem to think it is. If you and baby are healthy, and enough precautions are taken, there is no reason why a VBAC won’t work for you.