Why is the decision between VBAC (vaginal birth after caesarean) and repeat c-section important?

Why do I hear conflicting information about VBAC vs repeat c-section?

How can you learn about, decide on and plan for a VBAC or a repeat c-section?

Why is the decision between VBAC (vaginal birth after caesarean) and repeat c-section important?
If you have had one or more caesareans, your decision about whether to plan a VBAC (“vee-back”) or a repeat caesarean section can have far-reaching consequences for you, your baby, and any future pregnancies. You will want to become well-informed about VBAC, understand the trade-offs between VBAC and repeat caesarean, and weigh your own values and concerns so that you can come to a decision that is best for you. Once you reach a decision about VBAC delivery or caesarean delivery, careful planning can help you reach your goals.

Unfortunately, a growing number of hospitals and doctors, fearing lawsuits, do not allow you to weigh the facts, consider your preferences and choose for yourself regarding VBAC and planned repeat caesarean. If you wish to use their services, you must accept surgical delivery. Your best approach is to become informed and clarify your goals well in advance and then seek care that is in line with your preferences and birth plan.

Why do I hear conflicting information about VBAC vs repeat c-section?
During much of the last century, a woman who had a caesarean section almost always had a planned repeat c-section and not a VBAC for any births that followed. Doctors were concerned that the scar from the past cut in the uterus could open during labor (uterine rupture), and cause serious complications for mother or infant.

During the last quarter century, however, many health professionals, advocates, pregnant women, policy makers and researchers encouraged vaginal birth after caesarean (VBAC) in light of:

  • change in location of the uterine cut to an area much less likely to open during a VBAC labour
  • growing body of research establishing the safety of VBAC
  • growing recognition of c-section risks.

Now the pendulum is swinging back from vaginal birth after delivery, with new calls for routine repeat c-sections. This reversal leaves many women with caesarean scars struggling to make sense of conflicting, incomplete, and sometimes misleading information about the safety of VBAC vs. repeat c-section and about what birth plan to make this time around.

How can you learn about, decide on and plan for a VBAC or a repeat c-section?

It is difficult to find accurate information on these subjects and for this reason, after much research into the subject we have located an objective, accurate, research-based website which gives you the information which should make these decisions a little easier to make. Our aim at birthworks is to create reliable links to information and support to help you understand the issues surrounding planned VBAC vs. planned repeat caesarean. These links are to an american website www.childbirthconnection.org . Here, you will find:

Adapted from www.childbirthconnection.org to suit South African context

July 2007