Vaginal or Home Birth after a caesarean section
Childbirth is one of the most important and memorable events in a woman’s life. Such a life event should be recalled as positive and wonderful but some women may look back with mixed feelings of sorrow and even anger. These negative feelings can be the result of any type of birth but are very common in women whose babies were born by a caesarean section proving that recovery from a surgical birth takes much longer emotionally as well as physically. Many such women have reported feelings of guilt and disappointment that a ‘natural’ birth was not achieved especially if they feel that they were not part of the decision making process.
The good news is that in most cases, if wished, a subsequent, natural, vaginal birth is still possible and should always be discussed and considered with your care-givers. In almost all but the rarest of cases an automatic repeat caesarean section can be avoided.
Before making plans for a VBAC or repeat Caesarean section we help women to consider and understand the pros and cons of both procedures so that they can make an informed choice about what is best for them. Research has shown that VBAC is safe and that the risks of complications for both mother and baby are lower than with a repeat caesarean section.
Most hospitals have strict guidelines for women labouring with a caesarean section scar. These will often include continuous monitoring of the baby’s heart beat (this precludes women from a water birth and may severely restrict her ability to stay mobile) and the withholding of food and drink which may slow or stall the birthing process. These precautions are taken incase a repeat caesarean is required and to detect a possible uterine rupture ~ . when the womb (uterus) ruptures along the line of the old scar. This is a significant risk associated with a vaginal birth following a caesarean section but occurs very, very rarely. To put it into perspective; the likelihood of needing an emergency caesarean for any woman giving birth is 30 times higher than a woman having a VBAC experiencing a uterine rupture (Enkin 2000). This does not mean that we dismiss this risk; as experienced care-givers, we will be watching for signs throughout a woman’s pregnancy and labour and appropriate action will be taken if required.
Despite the fact that all women have the right to birth in the way that they choose and can decline any interventions that hospital staff may suggest some women feel that hospital policies ‘set them up to fail’ or take away the decision-making process from them. Some women may feel that they need an advocate for them in hospital or even that home is the safest place for their baby to be born.
We realise that birth can be an empowering and healing process. We are experienced in supporting women who choose a VBAC either in a hospital or a home environment and we are happy to discuss your plans to birth in the way you wish and will support your choices.