For a woman’s next birth after caesarean, she is faced with the choice between having a repeat elective caesarean section or a vaginal birth after caesarean (VBAC). If a woman fits the criteria for a VBAC, she should always be offered a VBAC before being booked for a repeat elective caesarean section. This is supported by discussing the benefits and risks of having a VBAC, the risks of a caesarean section, views of healthcare professionals, the impact on subsequent births and women’s beliefs on both VBAC and repeat elective caesarean section.
Benefits of a Vaginal Birth After Caesarean
A vaginal birth after caesarean should always be offered to a woman who fits the criteria for one. VBAC’s have been found to be more successful if the woman has had a previous safe vaginal birth and/or VBAC previously, has a low risk pregnancy, if it has been 18 months or more between deliveries (Ranzcog.edu.au, 2015), for women younger in age, for women whose previous caesarean section was elective (Stone, Halliday, Lumley & Brennecke, 2000) and who have a body mass index less than 30 (Shorten & Shorten, 2012). Dodd and Crowther (2003) found that for women with a parity of one, VBAC should be presented as an option for their next birth. They also suggest that a VBAC should be performed “in either a level two or three hospital, with the availability of an anaesthetist, neonatologist and operating theatre within 30 minutes” (Dodd & Crowther, 2003) and recommend “the use of continuous electronic fetal heart rate monitoring, intravenous access and routine blood for group and hold in labour” (Dodd & Crowther, 2003). Stone et al. (2000) found that to increase the numbe...
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...via is a complication that increases with the repetition of caesarean sections, along with placenta accreta (Ranzcog.edu.au, 2015). Despite these, it is still viewed that VBAC, if it is a considerable option, is the preferred option for women for their next birth after caesarean.
The evidence discussed in this piece has found that a vaginal birth should always be offered to women for their next birth after caesarean rather than the women having a repeat elective caesarean section, if they fit the criteria for a VBAC. This statement is supported by the increasing evidence showing the benefits of VBAC, the desires of women to birth naturally and/or to avoid a repeat caesarean, the negative aspects of a caesarean birth, and when considering future pregnancies. The risks of a VBAC must always be discussed with the woman so that she is able to give her informed consent.
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