Although vaginal birth after cesarean section (VBAC) is not preferred for every expectant mother, a healthy birth can be performed in suitable individuals, under appropriate medical conditions.
Because it is risky for mothers who gave birth by cesarean section in their previous pregnancy, normal delivery in their next pregnancy is preferred. The most important reason for this is that the incision made on the uterine wall during cesarean section is not like normal tissue on the uterine wall after recovery and is weaker than the old tissue. As a result, there is a risk of tearing the uterine wall during contractions in normal delivery. As a result, undesirable consequences may occur, up to loss of mother and baby.
The mother-to-be and her family should be informed in detail about the risks of vaginal birth after cesarean section. It should be explained that the risk of rupture of the uterus during VBAC is around 1-3%, and in case of rupture, maternal loss is 25% and infant loss is around 75%.
If the expectant mother who wants to have a normal birth after cesarean has had a normal birth before or has had a normal birth after a cesarean section, the probability of giving birth with VBAC increases. For normal delivery after cesarean section, at least 2-2.5 years must pass from the previous cesarean section. In normal births below this period, the risk of rupture, that is, rupture in the uterus, increases.
The expectant mother who will do VBAC is 37-38. A weekly gynecological examination should be done. The opening of the uterus, the weight of the baby, the position of the birth canal and the baby should be evaluated. If there is no obstacle to birth in the examination, 40-41. It can be expected for labor contractions by being followed closely until the next week. It is not recommended to give artificial pain to pregnant women who will do VBAC. Artificial pain increases the risk of rupture in the uterus. Therefore, spontaneous initiation of labor is recommended for VBAC.
VBAC is not suitable if there is a situation that prevents the expectant mother from giving birth normally, if the previous cesarean was performed with a vertical incision, and in case of narrowing of the birth canal. If the previous cesarean was made because the cervix did not open, normal delivery should not be attempted because the same situation is likely to recur.
For VBAC, there should be an environment and a center where the team is ready, which will follow the expectant mother very closely and where a cesarean can be performed within 10-15 minutes in case of a problem. VBAC can be tried when these conditions are met.