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VBAC or repeat C-section?

What you should know before making the call

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Originally published in Today's Parent August 2011

Andrea Natale, of Stevensville, Ont., and Heather Waller of Kingston, Ont., have never met. Nonetheless, the two women have a lot in common. Both strongly believe vaginal birth is ideal for babies and moms. Both had their first labours induced (Natale was overdue, and Waller had pre-eclampsia), and both ultimately delivered their first babies by Caesarean section when the procedure didn’t go as planned.

However, when it came time during their second pregnancies to decide between vaginal birth after Caesarean (VBAC) or repeat C-section, the two women made different decisions. For Natale, who opted for an elective C-section, the clinching factor was the 20-month spacing between her two births: Evidence suggests that such close spacing may increase the odds of uterine rupture. Waller, whose second pregnancy was complication-free, was determined to aim for a vaginal birth. At 41½ weeks, she got her wish: After going into labour on her own, she pushed out a nine pound, three ounce baby.

Despite the fact that their second babies arrived via different routes, Waller and Natale are both content with their choices. “I felt empowered by my decision, even though it was one I didn’t want to make,” says Natale. “My recovery after my first was horrendous because I had gone through hours of labour and pushing, then the C-section. The second time around, I was grateful to only have to recover from the surgery — it was definitely easier.”

And while Waller had mentally prepared herself to deal with a second C-section if necessary, she’s delighted she didn’t have to. “My recovery was a breeze — I had a shower right off the table,” she says. “I felt like a million dollars. And I was able to breastfeed this guy,” she adds, something she wasn’t able to do after her first birth.

If your first baby was born by C-section and you’re now expecting your second, you have a decision to make: Would you prefer to book a repeat Caesarean, or try for a vaginal birth instead? Thanks to modern medicine, the odds of something going seriously wrong during either scenario are very small. But before you opt for one path or the other, you need to know the pros and cons of each.

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