Why try for a VBAC?

What I remember most about the first time I gave birth are my husband’s tear-filled eyes above a surgical mask as we heard the words, “It’s a girl!”

I was strapped down to an operating table, completely out of it. After labouring naturally for more than 26 hours, our daughter had to be delivered via Caesarean section because her position in the birth canal made pushing ineffective. Everything about the experience is a blur to me.

I was grateful we were both healthy, but also felt my body had failed me, since I’d spent months preparing physically and emotionally for a natural birth. Breastfeeding and recovery were difficult after the surgery, and I felt that having to rely on others so much during those early weeks affected my ability to bond with my daughter.

Read more: Will I be able to have a VBAC?>

When I became pregnant again 19 months later, I assumed I’d have to plan for another C-section. I thought that was simply what was done in my situation.

But my midwife said I was a good candidate for a vaginal birth after Caesarean (VBAC), because the deliveries would be more than two years apart, and there was no indication my second labour would progress the same way my first did. Still, I was afraid to get my hopes up and I worried about potential risks.

Winnipeg mom Susie Erjavec Parker was so determined to have a VBAC that she was willing to switch doctors if she had to, just to make sure her goals were supported. “I had an active two-year-old and the idea of a six-week recovery from surgery was very unappealing,” she explains.

Read more: Is normal birth at risk?>

Jon Barrett, the chief of maternal-fetal medicine at Sunnybrook Health Sciences Centre in Toronto, says it’s important that your healthcare provider outlines your birth options. “A VBAC is very safe and viable for most women, if they are prepared to accept a small risk,” he says, referring to uterine rupture (tearing along the previous scar during labour), which happens in about 0.5 percent of VBAC attempts. But as long as there are no added risk factors, like a breech baby or deliveries occurring less than two years apart, the success rate is about 80 percent.

A VBAC poses less risk than a C-section for you (from bleeding, infection, operative injury and clots) and your baby (potential breathing and feeding difficulties). Recovery from a vaginal birth is also easier than from major abdominal surgery, especially when it comes to holding and feeding a newborn, or caring for older siblings. But the benefits of a VBAC extend beyond the physical: Many women have a deep desire to experience a vaginal birth.

Joanna Nemrava, head of the Department of Midwifery at Royal Inland Hospital in Kamloops, BC, and president of the Canadian Association of Midwives, says an unplanned C-section can be very disappointing for a first-time mom, and may leave her feeling detached from the final stages of the birth. “For a woman attempting a VBAC, it’s empowering to go through labour and to feel in control of her options, whether she’s ultimately successful or not,” says Nemrava.

Read more: Strategies for an easier labour>

Luckily, I was successful. I remember every detail about my son’s arrival, especially the weight of his warm body when he was placed on my chest. There was no curtain separating me from the moment he was born, and no surgical mask covering my husband’s joyful smile. It was exactly the birth experience I’d hoped for, and it helped to heal the disappointment I’d felt the first time around.

A version of this article appeared in our November 2013 issue with the headline “Why try for a VBAC,” p. 69.