Vaginal birth after ceasarean
Over the past few years, ceasarean rates have increased all over the world .
The World Health Organization (WHO) states LSCS rates should be around 10-15 % but rates in Australia are at least 30 % (closer to 40 % in many hospitals)
While the procedure is considered life saving for mum and / or baby in a percentage of birth, the rise in rates in concerning for many reasons .
One of the reasons most concerning is the reduction in choices for mums once they have had one LSCS .
Other concerns are that baby’s born by LSCS are not exposed to the vaginal flora which assists in the immune system.
Some of these microorganisms help to produce vitamins and anti-inflammatory substances.
Microorganisms in the gut are believed to play an important role in illnesses including Crohn’s disease and ulcerative colitis. An underdeveloped immune system may allow autoimmune diseases such as diabetes and rheumatoid arthritis to develop (U.S. National Institutes of Health, 2012). https://www.vbac.com/wp-content/uploads/VEP/VEP_TeachingGuide.pdf
Many mothers who have had a C-section for their first baby , are really keen to work toward a vaginal birth for their subsequent baby.
Vaginal birth after a ceasarean (VBAC)is often an option for mothers who have had a previous ceasarean for reasons which may not recur with a subsequent pregnancy or labour.
Some examples of non repeatable reasons may be a previous breech baby , low lying placenta , fetal distress in labour,
I often get enquiries from mothers who are looking toward their VBAC well in advance of the subsequent pregnancy.
My advice is always to do their research about their care provider !
Some care providers may say they support VBAC ,but as the pregnancy progresses mums begin to feel that they are coming up with new reasons to do a repeat C section at antenatal appointments.
When mums begin to feel unsupported, they need to trust their gut feelings.They need to ask more questions and request evidence .
A commonly used reason for not offering VBAC is that there is a risk of the scar rupture
Research outlines that there is also a risk of doing a primary or repeat LSCS .
Babies born by cesarean section without labor are more likely to be born preterm, have breathing problems, or need admission to a special care nursery. When mothers and babies are separated after birth and require medical care, mothers and babies are less likely to have the opportunity to be skin-to-skin, maternal-infant attachment is more likely to be delayed, and babies are less likely to be breastfed and continue breastfeeding during infancy (Jukelevics & Wilf, 2009). https://www.vbac.com/wp-content/uploads/VEP/VEP_TeachingGuide.pdf
So if you want a VBAC, choose your provider well
DO your research :
Read widely and know the actual risk of a LSCS as well as the risk of VBAC
Attend a childbirth education class which informs you and your support person about how positioning and spontaneous onset of labour matters
Surround yourself with like minded people and
Read successful VBAC stories
Consider hiring a doula (My Private Midwife offers doula service to only 1-2 clients month )