vaginal birth after caesarean

VBAC (Vaginal Birth after Caesarean)- Who can have one?

Pregnant women in Delhi considering a normal delivery have probably heard one or all of these lines before.

“You’re too overweight to have a normal delivery.”

“Why do you want to give birth yourself? A Caesarean will be so much easier.”

And perhaps the most common line of all:

“You’ve already had a Caesarean once. You can’t deliver yourself!”

Not surprisingly, this is exactly what Upali Mohanty had in her mind when she came in for her second delivery.

“My first baby was born by a Caesarean section at Sitaram Bhartia three years ago. My doctor  gave me a C-section because after twenty four hours of leaking and attempted induction, my labour did not start.”

However, she had a different experience for her second delivery.

Upali had a successful and normal VBAC (Vaginal Birth after Caesarean) delivery as her doctor did not see a reason for another caesarean because her pregnancy had progressed normally.

In fact, her doctor shared equal responsibility of a normal delivery with Upali.

“(She) said to me ‘if you give up, then even I can’t do it. We are all here to support you but you’re the one who has to do it.’”

Upali’s experience is becoming quite common at Sitaram Bhartia; 2 out 3 women attempting a trial of labour after a caesarean have a vaginal delivery with us. “Most women are candidates for a trial of labour after a Caesarean,” Dr. Kusum Lata Bhardwaj, Senior Obstetrician-Gynecologist tells us.

VBAC and Trial of Labour

The American Congress of Obstetricians and Gynaecologists defines a Trial of Labour after Caesarean (TOLAC) as “the attempt to have a vaginal birth after (a) caesarean delivery.” 3 out of 4 women who have had a caesarean can be offered a Trial of Labour.

Women and their families don’t readily accept the idea of a VBAC. The fear is that the uterine scar from the previous caesarean will rupture and cause serious complications for the baby and the mother.

Although, this is a serious occurrence, it is quite rare and women face a 0.3 -0.7% chance of a scar rupture. But that does not mean another caesarean by default if the pregnancy has progressed normally.

Is a VBAC Safe?

Approximately 60 to 80% of women who are offered a trial of labour end up having vaginal deliveries.

But a TOLAC should be offered in a well-equipped facility with a Neonatal Intensive Care Unit (NICU), on-site birthing support, a 24×7 Operating Theatre and continuous anaesthetic support. “At Sitaram Bhartia, our labour room is right next to our OT, so if an emergency does occur, we won’t waste any time in getting mom the help she needs,” Dr. Kusum Lata Bhardwaj said.

What are the Benefits of a VBAC?

And the benefits of a vaginal birth after caesarean? We could just let Upali speak for herself.

“When I had a caesarean, it was very painful; after my caesarean, I had to take care for at least six months. But now, after one day, I’m feeling good. I’m doing my own work and I can take care of my son myself.”

After the whole experience and nearly twenty hours of labour, did Upali think a normal delivery was a better choice for her?

According to her, she wouldn’t change anything. “(It) was not just better; a normal delivery is the best way to deliver a baby.”

Medically Reviewed by Dr. Kusum Lata Bhardwaj

MBBS Panjab University, Chandigarh (2008); MD Panjab University, PGIMER, Chandigarh (2012); DNB National Board of Examinations (2013)

Experience: 10+ years