Giving birth naturally after undergoing a cesarean section (CS) is often the hope and dream desired by many mothers. Although giving birth through normal delivery after a cesarean section (VBAC - Vaginal Birth After Cesarean ) can be a safe alternative, it requires special attention and thorough preparation.
What is VBAC ( Vaginal Birth After Cesarean )?
VBAC or Vaginal Birth After Cesarean is the process of giving birth naturally after a woman has previously undergone a cesarean section (cesarean section) for the birth of her first child or before. For many women, VBAC can be a safe and effective option. However, this depends on various factors, including the reason why the previous cesarean delivery was performed and the health conditions of the mother and fetus.
While VBAC offers many benefits, such as faster recovery and avoiding complications that often occur with cesareans, there are also some risks to consider, such as the possibility of tearing the previous cesarean incision during delivery. Therefore, it is important to consult with an experienced obstetrician to decide if VBAC is the right choice for you and your pregnancy.
Who Can Have a VBAC?
Not all women who have had a cesarean section can have a vaginal birth (VBAC). Some factors that influence whether a VBAC is a safe option include:
- Reasons for Previous Caesarean
If a cesarean section is performed for reasons of absolute indication, such as a narrow pelvis, abnormalities in the mother's pelvic bones, then VBAC cannot be performed. However, if the reason for the previous cesarean section was not an absolute indication and did not recur in the next pregnancy, for example due to placenta previa, labor not progressing, breech position, then it is likely that VBAC can be performed. - Number of Caesarean Section Incisions and Previous Surgical History
Women who have a history of one cesarean are more likely to successfully undergo VBAC compared to women who have a history of more than one cesarean in the uterus. This is related to the failure rate and the risk of tearing in the scar during VBAC delivery. Likewise, in women with a history of cesarean who have a vertical incision in the uterus (vertical), a history of uterine tumor removal surgery (such as uterine myoma), VBAC is not recommended.
Distance From Previous Caesarean History
The interval between pregnancies and previous cesarean history plays an important role in the success of VBAC. The recommended interval is at least 18-24 months, this is related to the risk of tearing in the previous cesarean scar.
- Maternal and Fetal Health Conditions
The health of the mother and fetus are important factors in the decision to choose VBAC. If there are health risks to the mother or fetus, or if there are complications in the pregnancy, then a cesarean may be preferred. - Fetal Size
Fetal size also needs to be considered, as larger babies (over 4 kg) may require more consideration as to whether VBAC is safe to perform. - Single and Normal Pregnancy
Pregnancy with one baby in a head-down position (cephalic presentation) also increases the chances of a successful VBAC.
Tips and Preparation for Normal Birth VBAC
Here are some tips that can help you better prepare for a VBAC:
- Consult with an Obstetrician Specialist
The first and most important step is to consult an obstetrician and gynecologist. The doctor will conduct a thorough evaluation of your condition, including the reasons behind your previous cesarean section, your physical health, and the condition of your developing fetus. This evaluation is crucial to determine whether VBAC is a safe and appropriate choice for you.
- Choose a Hospital with Complete Facilities
Choose a hospital that has complete facilities and an experienced medical team that is ready to handle complications if they occur. Complications that can occur are worsening in the mother, namely the threat of tearing in the previous surgical scar. Or worsening in the fetus, namely fetal distress. At the Hospital, the medical team is equipped with sophisticated equipment and experience in performing VBAC, which will monitor the labor process closely to ensure the safety of the mother and baby.
- Perform Routine Pregnancy Monitoring
Regular pregnancy monitoring is essential in identifying potential complications. Through ultrasound examination, fetal heart rate monitoring, fetal growth monitoring, maternal health checks, doctors can ensure that all aspects of pregnancy are running smoothly.
- Maintain Physical and Mental Health
Having a healthy body greatly supports the success of VBAC. Try to maintain a healthy diet, do regular prenatal exercise according to your doctor's recommendations, and get enough sleep to prepare yourself for labor. In addition, maintaining mental health is also very important, because stress and anxiety can affect the labor process.
- Improve Mental and Emotional Readiness
Having a vaginal birth after cesarean (VBAC) requires mental and emotional preparation. You may feel anxious about the birth process, or worried about possible complications. This is normal, but it is important to discuss with your doctor and other health care providers to minimize your worries. Childbirth education and family support can go a long way in building confidence.
- Understand Potential Risks and Complications
It is important to understand that while VBAC has many benefits, there are risks such as tearing of the cesarean incision. Consult with your doctor to understand these risks and how to manage them.
- Prepare for All Possibilities
Even if you decide to try a VBAC, there is a possibility that in some situations, complications may occur during labor that could be life-threatening to both mother and baby if continued. If any of these complications occur that threaten the life of the mother and/or baby, the attempted VBAC must be stopped, and an emergency cesarean section must be performed. Therefore, it is important to remain prepared and open to this possibility. Your doctor and medical team will ensure that all steps are taken to ensure the health and safety of you and your baby.
Benefits of VBAC Normal Childbirth
Having a natural birth after cesarean (VBAC) has many advantages, including:
- Faster Recovery Process
Recovery after a vaginal delivery is usually faster than a cesarean. You can get back to being active, breastfeeding, and taking care of your baby more quickly. - Reducing the Risk of Complications in the Next Pregnancy
Giving birth naturally reduces the risk of complications in subsequent pregnancies or deliveries compared to multiple caesarean sections. - Less Abdominal Pain
With a VBAC, you won't have to go through a large incision in your abdomen, as you would with a cesarean section.
Conclusion
Having a vaginal birth after cesarean (VBAC) can be a safe option for many women, with proper preparation and medical support. Obstetricians and Gynecologists at EMC Hospital are ready to provide careful guidance and supervision to help you have a safe vaginal birth after cesarean.
Article written by dr. Widi Astuti, Sp.OG (Obstetrics and Gynecology Specialist, EMC Pekayon Hospital).