There are many myths surrounding VBAC (Vaginal Birth After Caesarean). There is no such thing as one size fits all when it comes to labour and birth… It is important to understand how your individual circumstances influence the options available to you. No two births are the same. Here we address some of the myths that pop up regularly.
Myth: Caesarean Section is safer than Vaginal Birth following a previous Caesarean.
Fact: They are both extremely safe in Australia where we have excellent Health Care and women and their babies are monitored closely during labour. There is risk with either option. Depending on a person’s individual circumstances, they might be recommended a Caesarean Section because it is the safest option for them, not because it is the safest option for everybody.
The main risk associated with Vaginal Birth after Caesarean is that the scar will come apart during labour. This is called uterine rupture and the statistics are that it occurs in 1 in 200 births. It is important to discuss your situation with your Health Care Providers as your individual risk may be higher or lower than this.
If your Health Care Providers are advising that you have a choice and that it is up to you, then you can consider them equally safe. There are also things you can do to increase your chances of a successful VBAC.
Myth: My baby got stuck last time because my pelvis is too small
Fact: It is very rare for a woman to grow a baby that is too big for her own pelvis. For the vast majority of the time, if a labour doesn’t progress it is because the baby isn’t in the right position, not because it was too big. During labour, the labour hormones allow the diameter of a woman’s pelvis to widen to accomodate the baby moving through. As the baby rotates through the pelvis, the baby’s skull moulds and the diameter of the baby’s head gets smaller. Just like in Real Estate, it is all about Position, Position, Position! Sometimes babies get themselves into a position that makes labour much more difficult.
As you can see from the images above, the position of the baby’s head as it makes its way down through the pelvis, has a massive influence on whether or not it is going to easily fit. The ‘Moderate Flexion’ and ‘Deflexed’ positions are much more commonly associated with a delayed labour or Posterior labour. Rarely is it just as simple as ‘the head is too big’ or ‘the pelvis is too small’.
This is why it is really important to debrief your previous birth to understand what actually happened. Just because it happened last time, doesn’t mean it will happen again, and there are many ways you can influence the position of the baby. Our Online Antenatal Program for women planning a VBAC covers this in lots of detail.
Myth: Labour was long and awful and I ended up having a Caesarean anyway… the same thing will probably just happen again.
Fact: If your labour was long and awful, there are two things for you to think about this time. Firstly, second labours are almost always faster than the first. Secondly, because you are having a vaginal birth after a Caesarean Section and you have the scar, your Health Care providers will monitor your progress very closely. If it looks like there is any disruption to the normal flow of labour and it stalls for any reason, there will be a much lower threshold for recommending a Caesarean Section. Basically this means that if labour is working well, you will keep on going. If it is not, then you wont be encouraged to continue as you would have been under normal circumstances. There is no guarantee that you wont end up with another Caesarean Section, but you are very unlikely to have a long drawn-out labour.
Myth: Caesarean Section is easier
Fact: Unlike vaginal birth, a Caesarean Section is major surgery which takes time to recover from. It significantly limits what you can do in the weeks after the birth, which can be challenging when you have other children to care for. Yes, you don’t have to experience labour pain, but that is usually over within a few hours and can be managed.
It might seem easier because you can schedule the birth. It certainly is more predictable for those around you, but a vaginal birth allows you to be feeling well and able to care for yourself and your baby much sooner. There is also evidence to suggest breastfeeding is more likely to be successful after a vaginal birth.
So there you have our take on the Myths surrounding VBAC. As always, your Health Care Professional (not your hairdresser, aunty, friend, mother-in-law or neighbour) is the best source of truth when it comes to deciding the right path for you.
For more information NSW Health has a brochure (in many languages) that provides you with an overview of your next birth after a Caesarean Section. Queensland Health also has a VBAC parent information brochure.
If VBAC is right for you then our Online Antenatal Class will prepare you for how your labour will be different and help you maximise the chances of success.
We wish you all the best…