(Vaginal birth after two ceasareans is sometimes abbreviated to VBA2C. Vaginal birth after three ceasareans is VBA3C, and so on.)
Many women internationally have had successful vaginal births, after two or more previous ceasareans. However, you will still find some pregnancy books and many obstetricians who will suggest that your only option after two ceasareans is a repeat section. This attitude is particularly prevalent in South Africa in the obstetric private sector. This view is not supported by either the evidence, or by expert opinion.
‘A Guide to Effective Care in Pregnancy and Childbirth’, which is a well-respected summary of evidence-based practice, says:
“The available data show that among [women who have had more than one previous ceasarean] the overall vaginal birth rate is little different from that seen in women who have had only one previous ceasarean section. Successful trials of labour have been carried out on women who have had three or more previous ceasarean sections.”
“The rate of uterine dehiscence in women who have had more than one previous ceasarean section is slightly higher than the dehiscence rate in women with only one previous ceasarean, but dehiscences in the reported series tend to be asymptomatic and without serious sequelae. No data have been reported on other maternal or infant morbidity specifically associated with multiple previous ceasarean sections.”
“While the number of cases reported is still small, the available evidence does not suggest that a woman who has had more than one previous ceasarean section should be treated any differently from the woman who has had only one ceasarean section.”
– From ‘A Guide to Effective Care in Pregnancy and Childbirth’ 3rd edition, by Enkin, Keirse et al, Oxford University Press, 2000 (p363-4)
Below are some links that may help to inform you of your options:
- A very comprehensive website, written by a VBAC mother, is dedicated to this subject:vaginal birth after two or more caesareans, by KMom
- Elective section after two sections – Where’s the evidence?
- VBAC – On Whose terms?
- Do Mothers Put Their Babies At Risk?
- VBAC: the facts, the issues
- The Childbirth Connection Website on VBAC or repeat C-Section