Can you have a natural birth after a c-section? Short answer, most likely, but it depends on a few important factors. By the way, this type of birth is called a VBAC, and here’s everything you need to know about it!
Putting aside the fact that the term “VBAC” sounds more like something you’d call an HVAC guy for than a term for vaginal birth after a c-section, it’s actually fairly common. Once upon a time, women were told that if they delivered one baby via c-section, then they’d have to deliver all their babies that way. Doctors didn’t really even ask how you wanted to deliver your next baby, they just scheduled your c-section like it was written in stone.
Thankfully, both medicine and doctors have evolved with the times, realizing that a whopping 90% of women who delivered by c-section were candidates for a VBAC with their next baby, according to American Pregnancy. Here is everything you need to know about having a natural delivery after a c-section.
Can you have a natural birth after a c-section?
We already determined that a HUGE percentage of women who give birth by c-section are perfectly capable of going on to have a natural delivery with their next baby. In fact, more and more doctors are getting on board with a trial of labor after cesarean (TOLAC). That’s their fancy way of saying “hey, we’ll give VBAC a try and see how it goes!” Of course, it’s not always as cut and dry as statistics make it seem. Let’s look at what makes a good candidate as well as the potential complications and other things to consider.
Why would you consider having a natural birth after a c-section?
First, I think it’s important to clarify what we mean when we say “natural birth after c-section.” For the purposes of this article, I’m talking about vaginal delivery. There are SO many ways to define “natural birth” these days, from hospital births with a myriad of pain relieving options to home deliveries in a relaxing pool of water. It’s easier if we stick to just defining it as a vaginal delivery, otherwise things get all sorts of confusing.
So, why would you consider having a natural birth after a c-section? I think the answer is pretty obvious. No one really wants to be cut open! I delivered my son via c-section and the recovery was kind of a nightmare. Granted, I had extenuating circumstances (namely, an improperly closed incision that burst open, got infected, and had to be packed for six weeks), but still. Even under the best of circumstances, your recovery time is far longer than when you delivery “naturally.”
Beyond the obvious reason, though, there are other reasons to consider VBAC. These include:
1- Lowering the risks associated with c-sections
While c-sections are generally safe procedures (after all, about 32% of pregnant women have one), it IS a surgery and comes with risks. These run the gamut from minor infections to major bowel and bladder injury. Each surgery also creates new scar tissue, which can later adhere to your colon, bladder, ovaries and pretty much everything else in its path. The only way to get rid of scar tissue is to cut it out, which in turn creates MORE scar tissue.
2- Potentially preserving fertility
While it’s unlikely that a c-section will damage your future fertility, those aforementioned adhesion CAN wreak havoc on your future baby-making efforts. In fact, c-section adhesions interfere with future fertility in about 20% of cases. Note that I mean 20% of all women with adhesions have difficulty getting pregnant, not 20% of all c-sections in general.
3- Emotional reasons
Medical benefits aren’t the only reasons to consider a VBAC. For many women, it comes down to the emotional investment in the delivery. When I got pregnant with my son, I planned to have a “natural” delivery. Okay, so to me, that meant a vaginal birth but with a big old epidural to ease my pain, but still, I had this perfect vision in my head of how my delivery would go. It took me forever to get pregnant in the first place, and I wanted the whole Hollywood experience. Rushing to the hospital, my family around me in the delivery room, that amazing moment when they lay your newborn on your chest for the first time.
I didn’t get any of that. Instead, I got rushed to the hospital at 32 weeks because my kidneys were failing and my blood pressure was astronomically high, thanks to preeclampsia. Then I got an emergency c-section a day later because my son’s heart rate was dropping. Since he was a preemie, the whisked him away before I could so much as get a glance. I didn’t really see him until over 24 hours later. It took me a long time to get over the fact that I didn’t get to have my perfect Hollywood birth experience, so I can totally understand how another mom-to-be would choose a VBAC for emotional reasons.
What makes you a good candidate for VBAC?
Whatever your reasons for choosing VBAC, there are a few things that factor into whether or not it can happen for you.
- Previous vaginal delivery. If you’ve had a successful vaginal delivery in the past, then you are more likely to tolerate a VBAC.
- Your baby’s weight. your previous babies weigh, on average, less than 8 pounds. Large babies aren’t a deal breaker, but they do increase the chances of needing a c-section.
- Your pregnancy-related health. If you needed a c-section because of placenta previa, fetal distress or because your baby was breech, then there is a higher chance you’ll have the same problems with subsequent pregnancies. While I opted to have an only child and my baby-making boat has sailed, if I did have more babies, my risk of developing preeclampsia again is pretty high, especially because it came on so early in my pregnancy. Again, that’s not a VBAC deal breaker, but it does make things more complicated.
- Your labor is progressing relatively normally. A ton of factors come into play during labor itself. Is labor advancing on a fairly normal schedule? Are you dilating at a reasonable rate? Is your baby in a good position? Again, none of these things are the be all/end all for determining if you can have a VBAC, but they definitely help.
Every single pregnancy is different, and honestly, only your doctor (or midwife) knows if you’re a good candidate for a natural birth after a c-section. While how you deliver is your personal decision, I highly (HIGHLY HIGHLY) recommend delivering in a hospital just in case things go awry and you end up needing a c-section at the last moment, at least for your first VBAC. If that goes off without a hitch, then you can talk to your doctor about other options if you have your heart set on a home birth experience.
What are the potential risks?
There are potential risks with a VBAC as well. These include:
- Failed labor (basically, your labor didn’t progress or go as expected). In this case, your doctor may decide that you need a c-section after all.
- Uterine rupture: this is the biggest risk, since it’s the most dangerous. It happens when your uterus bursts along the scar line from your previous c-section. It’s rare, occurring only in about 1 out of 100 VBAC deliveries. Still, it’s crazy scary and needs immediate attention.
- Risks associated with a vaginal delivery: The rest of the risks can occur in both VBACs or in women who never even had a c-section. These include things like tearing, hemorrhaging, and blood clots.
Again, like the benefits, there may be other risks specific to your pregnancy, so you’ll need to discuss them with your doctor.
Bottom line, VBACs are becoming increasingly common and, for most women, having a natural birth after a c-section is totally possible. It’s incredibly important to discuss it with your doctor early in your pregnancy. This allows you and your doctor to come up with a TOLAC plan that is best for you. It also gives you plenty of time to find another doctor if yours just isn’t comfortable with it. While the majority of OB/GYN doctors are up to date on the risks and benefits, a few still feel repeat c-sections are the best way to go and flat out refuse to consider a VBAC. This has more to do with litigation worries if something goes wrong than your actual chances of a successful natural birth after a c-section. Of course, if 5 doctors say it’s not a good idea, you may need to adjust your plan.