If you needed or wanted to have a caesarean birth in a previous pregnancy, you may wish to have a vaginal birth this time.
Vaginal birth after caesarean (VBAC) is safe but there are a few things that you might need to discuss with your midwife or obstetrician (specialist doctor) as well as friends and family before you make your decision.
You will be offered the chance to discuss the options available with a consultant or specialist midwife.
The reason for your last caesarean may be important for your decision-making in this pregnancy. Depending on what they were, the reasons you had the last caesarean may or may not affect this birth. In many cases, there is no reason to expect the same complications, and the chance you will need another caesarean is about the same as in your last pregnancy.
Having had a vaginal birth before raises your chances of a successful VBAC.
By having a VBAC, the risks of abdominal surgery are avoided. If your baby is born vaginally, they are much less likely to need support with breathing at birth.
Recovery from a vaginal birth is usually faster than recovery from a caesarean. Most mothers who have a vaginal birth find caring for their baby (and other children) far easier after a vaginal birth than after a caesarean.
For women who plan to have more pregnancies in the future, avoiding further scars to the womb increases the chances of a healthy future pregnancy.
One in 200 women who labour after a caesarean will experience scar rupture where the old scar reopens. (This is the scar on the womb, not the scar on the skin). This is potentially dangerous for both mother and baby and is why close monitoring is advised for VBAC labour. In practice, although rapid emergency caesarean is required if this happens, the overall chance of a poor outcome for the baby with planned VBAC is tiny. It is no bigger than the risk faced by a first time mother in labour.
During your VBAC you will be offered continuous monitoring so that the team looking after you during the birth can keep an eye on your progress. You and your baby will be monitored closely, and your midwives will look out for signs of scar rupture. If there are signs that things might not be progressing as they should or there might be a problem, this will be noticed early and you will be offered a caesarean if necessary.
