VBAC (Vaginal Birth after C-Section): What You Need to Know

We’ve previously blogged about caesarian sections (C-sections) including what you can expect during the procedure as well as potential risks. This week, we explore the related topic of VBAC (vaginal birth after C-section).

Giving birth vaginally after having a previous caesarian birth can be an alternative to having another C-section, however, there are risks involved.

Risks Associated with VBAC

There are some risks associated with a VBAC, which are important to keep in mind. These include:

• Uterine rupture, which is a tear along a previous c-section scar. Should a uterine rupture occur, an emergency c-section will be done.
• The need for a repeat, potentially emergency/urgent c-section, if there is an unexpected issue during labour.

A uterine rupture is a dangerous emergency for both the mother and the baby. It can lead to the mother requiring a blood transfusion, and/or a removal of the uterus (hysterectomy). In rare cases, maternal or infant death can occur following a uterine rupture, especially if immediate action is not taken to protect both woman and baby.

Other risks of VBAC are those that exist for any vaginal birth and include:

• Perineal tearing and stitches;
• Leaking of urine for the first three months after birth;
• Prolapsed uterus;
• Uterine infection; and
• The need for a blood transfusion.

Risks associated with VBAC increase for women who:

• Had a c-section less than 18 months prior to their VBAC;
• Have had more than three c-sections;
• Are older than 35;
• Have a body mass index (BMI) greater than 30kg/m²; or
• Are given medication to induce or augment their labour.

Candidates for VBAC

Women considering a VBAC should discuss their plan with their OB-GYN, midwife, and other health care providers. Not everyone can have a VBAC, and VBAC should only be considered if:

• The incision in the woman’s uterus during a previous c-section(s) was made horizontally across the lower part of the uterus;
• The woman has not had any surgery where an incision was made in the uterus (other than the c-section(s);
• The uterus has never ruptured;
• The reason a c-section was previously needed is not an issue this time; and
• There are no other reasons why the woman should not give birth vaginally.

If a C-section was previously needed for a reason that will not change, such a mother with a small pelvis, then another C-section will likely be required. However, where a woman previously had a C-section due to something specific to those circumstances, such as a breeched baby, a VBAC may be possible.

Alternatives to VBAC

The alternative to VBAC is a planned repeat C-section. These are generally scheduled for the seven days leading up to a woman’s due date, unless the baby needs to be born sooner for a medical reason.

What You Can Expect During a VBAC

The primary difference between VBAC and a standard childbirth is how closely the mother will be monitored. The baby will have continuous electronic fetal monitoring, and the mother’s contractions will be measured at all times.

The medical team will be watching for any signs of uterine rupture. If the baby’s heart rate does not sound right, that could be an early sign that there may be an issue.

If you have questions about the medical care provided to you during labour and delivery, or you suspect that something out of the ordinary occurred, contact the Toronto-based medical malpractice lawyers at Sommers Roth & Elmaleh. We are highly respected in both the medical and legal fields and offer compassionate, knowledgeable, and skilled guidance on all aspects of medical malpractice claims.  Call us at 1-844-777-7372  or contact us online for a free consultation.