Is Normal Birth Possible After Cesarean?

Obstetrics and Gynecology Specialist Op. Dr. Miray Sekkin Eser gave important information about the subject. Vaginal birth after cesarean section (VBAC) is one of the birth types that has been researched a lot recently. There are many reasons why VBAC patients want VBAC. Awareness of the patients on this issue also increases the requests for VBAC.

Is VBAC suitable for every pregnant woman?

Some conditions are sought in patients who apply with a request for VBAC. These:

• The previous cesarean section was made with a transverse incision in the lower part of the uterus, at least 2 years
• Absence of an operation or anomaly other than cesarean section from the uterus
• The woman does not have pelvic stenosis, the previous cause of delivery is not cephalopelvic incompatibility
• Appropriate head delivery and birth position of the baby under 4000 g.
• The fact that the birth follow-up has been carried out by a doctor from the beginning and the emergency cesarean section conditions are provided
• Presence of anesthesia conditions that can intervene urgently if needed
• Appropriate conditions for the need for blood transfusion

What are the risks of VBAC?

The greatest risks for VBAC are the situations that may occur with the opening of the old suture during delivery. This risk is between 0.5-1.5%. This risk can be evaluated according to the previous suture site. But even this risk is considered and tried to be prevented because it can be vital. Having a previous history of vaginal delivery reduces the rate of going to cesarean section.

• VBAC rate 63% if there was no previous vaginal delivery
• If there is 1 vaginal delivery, the rate of VBAC is 83%
• If 1 VBAC was performed, the rate of repeat VBAC is around 94%.

During VBAC, the probability of emergency cesarean section is stated to be around 30% according to the labor guideline. Again there are fetal distress and newborn needs for the baby. The risk of infant loss due to birth has been reported as 2-3 per ten thousand.

Giving pain during VBAC is risky. For this reason, it is expected that the contractions start spontaneously. The aftermath is like a normal vaginal delivery. Progression of labor and NST follow-ups are important. The person may or may not have an episiotomy. Recovery time is usually fast, like normal delivery. It usually results in success in women who consciously choose VBAC and can take the necessary steps on this path. Preparing for birth properly and being physically and psychologically ready increase success rates. A team that supports VBAC and has experience also increases the success rate. However, it should be kept in mind that every birth has risks and may result in a cesarean section.