What is a VBAC?
A VBAC (vaginal birth after cesarean), is when you deliver a child vaginally after having one previous cesarean delivery. A VBAC can also be referred to as TOL which means ‘trial of labour after cesarean.”
Why a C-section may have occurred
A cesarean birth may have previously occurred for the following reasons:
Difficult or slow birth
Previous cesarean birth
Sometimes there are other issues in previous pregnancies that may have resulted in a c-section (like placental issues). Based on your past pregnancy history, your OB or Midwife will help you determine if you’re a good candidate for a VBAC.
What are the benefits of a VBAC?
Empowering birth experience: Pregnant people often feel more in control of their birthing experience, which can help reduce feelings of fear and anxiety.
Faster recovery time: Recovering from a vaginal birth is typically faster than a cesarean delivery, and may require a shorter hospital stay.
Decreased risk of complications: Oftentimes having a vaginal birth reduces the risk of surgical and other common complications like infection, hemorrhage, or blood clots.
What are the risks of a VBAC?
Risk of uterine rupture: Uterine rupture is a rare but serious complication that can occur during a VBAC. Depending on the scar thickness, it may rupture during birth because of uterine expansion and contraction.
Your OB or Midwife might send you for an ultrasound late in the third trimester to determine your scar thickness to determine if you would be a good candidate for a VBAC.
Are there any contraindications for a VBAC
If you’ve experienced any of the below, you won’t be a good candidate for a VBAC:
Previous classical or inverted “T” uterine scar (rather than a horizontal scar)
Previous hysterotomy or myomectomy entering the uterine cavity
Previous uterine rupture
Presence of a contraindication to vaginal birth
Can I do acupuncture to induce labour?
This is tricky. You can try acupuncture to induce labour if you’re attempting a VBAC - but I would get the clear from your OB or Midwife first. This is because your uterine scar tissue may be too thin (we don’t want a rupture to happen!), or the time interval between the cesarean birth to next birth may be too short (ex. between 18-24 months).
A stretch and sweep leading up to birth may be offered during your prenatal visits to help with cervical ripening. Sometimes your care provider may recommend a Foley catheter for cervical ripening - which isn’t associated with a risk of uterine rupture, but is not always successful. Pitocin for induction (usually at a smaller amount that normally provided) may also be offered, which is also safe during birth.
Can you have a VBAC at home?
For a safe birth, the Society of Obstetricians and Gynecologists of Canada recommends that VBACs be done at the hospital where the pregnant person and their fetus be observed for any complications.
Next Steps
About 75% of women who have attempted a VBAC have been successful (me included!). If you don’t have any of the above contraindications and you’ve spoken to your OB or Midwife about your specific case, then it may be worth a try!