Vaginal Birth After C Section Complication
Vaginal birth after cesarean (VBAC) means giving birth through your vagina after giving birth previously by cesarean section (C-section). A C-section involves making a surgical cut (incision) through your belly, then removing the baby through that incision.
Although VBACs are generally safe, there are some risks associated with them. Some women have experienced severe complications during and after the procedure as a result of medical mistakes.
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VBAC (Vaginal Birth After Cesarean) Has Been Successful
Women who have had previous C-sections often wonder whether they can have a successful vaginal birth for any future pregnancies. Vaginal birth after C-section is a common practice that many pregnant women choose after having a Cesarean in the past.
According to the American Pregnancy Association, 60-80% of women that have chosen VBAC have been successful. Although this decision contains risks, it can be beneficial for women that meet specific criteria.
Cesarean delivery comes with a surgical scar and longer recovery times, and vaginal birth after Cesarean may also be unsuccessful after a lengthy trial at labor.
Both C-sections and vaginal birth after Cesarean delivery have risks and benefits that can be different for each pregnant woman. Before making a choice, it is vital to understand risk factors, benefits, and personal health history.
What Is a Vaginal Birth After a Cesarean (VBAC)?
Vaginal birth after C-section is when a woman has a vaginal delivery in pregnancy after a previous cesarean delivery (C-section). C-sections require a surgical cut through the stomach and uterus to remove the baby.
Successful VBAC is more common in women that are not high-risk or have any preexisting uterine issues. Women who wish to have more children may also consider birth after cesarean delivery (VBAC) to allow them to have more pregnancies with less risk.
Are You a Candidate for Vaginal Birth After Cesarean (VBAC)?
A healthcare professional will evaluate pregnant women for the safest method of delivery starting at their first prenatal visit. This evaluation will take into account any previous abdominal surgery, uterine scars, and overall health.
The following criteria can make you a safe candidate for a VBAC attempt:
- You have no more than two previous C-section deliveries.
- You have no other uterine incisions.
- You are pregnant with no more than one baby.
- You have experienced prior vaginal delivery.
- You have no placenta problems, such as placenta previa.
- You have prior vaginal birth success.
- You have a low transverse incision.
- You have no previous uterine ruptures.
- You have a body mass index of less than 50.
You will also want to plan delivery at a facility capable of dealing with an emergency C-section and any complications that may occur should these measures be needed. Some hospitals and delivery facilities may not offer VBAC options if they do not feel they have adequate staff or equipment to handle all potential emergencies.
Benefits of VBAC
Many women that have had C-sections remember lengthy and painful recovery from their surgeries. They may feel defeated from their first attempt to birth vaginally without success, and they may be ready to try again with a future pregnancy.
Vaginal birth after Cesarean allows women to experience natural childbirth without the complications and recovery of surgery. It appeals to those who do not want to repeat the same process as their previous delivery.
Women that wish to have multiple pregnancies will typically advocate for VBAC. Vaginal delivery removes the risk of placental and abdominal problems that can occur with multiple Cesarean deliveries.
After both you and the baby are assessed, you can attempt VBAC and experience the benefits of vaginal birth, such as:
- Shorter recovery time
- No abdominal surgery
- No uterine or skin scar
- Less blood loss
- Less risk of infection
- Individualized delivery plan
The baby can also benefit from a vaginal delivery. As the baby passes through the birth canal, their lungs are cleared, and their immune systems are boosted with good bacteria. It prepares them to breathe oxygen better and cope with infection after birth.
Possible Complications of Vaginal Birth After Cesarean
Although successful vaginal birth after a Cesarean (VBAC) often has fewer complications than a repeat C-section, a failed trial of labor can lead to more severe complications. These can occur both during the delivery attempt and in the postpartum period.
The rupture, or tear, of the uterine wall, is a concerning complication while pushing during vaginal delivery. This pushing causes pressure in the lower abdomen, which can cause the uterine incision to tear. When the Cesarean scar is ruptured, an emergency C-section is needed to prevent life-threatening complications in the mother and baby.
According to MayoClinic, uterine rupture occurs “in less than 1% of women who attempt a trial of labor after cesarean.” Although uterine rupture is rare, it can lead to quick, severe, and even fatal complications.
If the uterine ruptures, there is a risk of:
- Blood loss
- Bladder damage or infection
- Internal bleeding
- Blood clots
- Possible hysterectomy
Risk of Infection
Women that attempt birth after Cesarean delivery but do not have a successful vaginal delivery double the risk of infection. If a Cesarean birth is necessary to safely remove the baby, birthing mothers are more susceptible to infections from their vaginal attempt and the C-section procedure. These infections can cause discomfort during postpartum recovery and a more extended hospital stay.
Even with a successful birth after a Cesarean (VBAC), women may still have postpartum complications, like excessive bleeding and possible hemorrhage. Heavy bleeding after giving birth requires medical attention.
If you notice heavy bleeding, a loss in blood pressure, or feelings of shock, contact a doctor immediately.
In severe circumstances, the damage to the uterus may be too extensive if it ruptures. A hysterectomy, or removal of the uterus, is necessary when this occurs. It will prevent you from having more children in the future.
Understanding C-section Incisions and Their Risks
Women who have previously delivered surgically are left with a C-section incision on their uterus and stomach. These incisions are made to remove the baby safely from the uterus when a vaginal birth is not possible or not preferred.
Different C-section incisions can affect eligibility for VBAC in future pregnancies. It is important to understand the types and how they impact your risk of complications during an attempted VBAC.
- Low transverse incision- The most common uterine incision is cut across the lower and thinner part of the uterus. It carries the least amount of risk for VBAC.
- Low vertical incision- When a cut is made vertically in the lower, thinner part of the uterus, it presents more risk during vaginal birth.
- High vertical incision- Cuts may need to be made higher in the uterus, the thicker layer. Women with this incision pose a higher risk of complications during VBAC and often will not be considered a safe candidate for the procedure.
The outer incision on the skin of the stomach does not always match the incision type or direction used on the uterus from your prior C-section. It is essential to consult with an OBGYN and look closely at your medical records. It will give you truthful information about your last cesarean delivery and the reasons for the procedure.
What to Expect During a VBAC Labor
Giving birth after a Cesarean (VBAC) will be similar to the process of routine vaginal delivery. However, mothers with a previous Cesarean will be closely monitored during the trial of labor. Both women’s health and child health are considered before making any decisions.
To prevent complications during birth after Cesarean delivery, your doctor will closely monitor the baby’s heart rate, lungs, and any signs of distress to determine whether a repeat C-section is needed or whether a successful VBAC is underway.
How to prepare for a successful VBAC:
- Talk about the risks and possible complications
- Discuss reasons for your previous C-section
- Choose a well-equipped facility that offers VBAC
- Put safety first
- Ask questions to reduce anxiety
It is important to stay flexible in your birth plan when attempting vaginal birth after a Cesarean. As the labor continues, there may be concerning factors or issues.
Complications that may arise in labor to reduce chances of vaginal birth after cesarean include:
- Labor induction- Being induced will decrease the chances of successful vaginal delivery.
- Breech baby- A baby in breech is facing with feet or bottom first in the uterus. Typically, babies will turn head-first by 36 weeks. If this does not occur, the doctor can attempt to turn the baby or recommend C-section.
The doctor may recommend Cesarean delivery instead of induced labor when these complications arise. The circumstances of labor will determine the safety and best delivery method to put the health of the baby and mother first.
What Happens If a VBAC Attempt Is Unsuccessful?
Although successful vaginal birth after Cesarean is common in women with lower risk factors, 20-40% of women will have unsuccessful attempts to emergency repeat C-sections.
Cesarean delivery has become a more popular method of delivery in the most recent years. The American Pregnancy Association reports that 1 in 4 women will experience a Cesarean delivery. These surgeries may be a part of the delivery plan, while other times, they occur unexpectedly in emergency circumstances.
C-sections carry surgical complications and risks to the mother, including:
- Infection of the uterus, bladder, or uterine incision
- Excessive blood loss
- Injury to abdominal organs
- Extended hospital stay
- Longer recovery time
- Risk of additional surgeries
C-sections carry risks to the baby, including:
When Cesarean delivery is done in an emergency, these risks can increase. Failed VBACs that result in emergency Cesarean delivery occur quickly in reaction to distress or danger to the mother or baby.
Hire a Medical Malpractice Attorney to Resolve Your Personal Injury Claim
Are you the victim of medical malpractice involving your pregnancy? At Rosenfeld Injury Lawyers, LLC, our personal injury attorneys are legal advocates for injured victims harmed through another's negligence.
Call us today at (888) 424-5757 (toll-free phone number) or use the contact form to schedule a free consultation. All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.
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