Had a previous cesarean? You should go for a VBAC, heres why!

The cesarean rate in Alberta and even in Canada, at the moment, is around 15% higher than the WHO (World Health Organization) recommends. I can't say I am surprised at this statement, since so many of the people I talk to have had cesareans. I'm included in this population, so I know how valuable they are when needed. At the same time, as a doula and a childbirth educator, I can't help but feel sad that cesarean rates are so high and not really budging at the moment. A part of the problem is the fact that most of the cesareans performed (76.1% in Alberta to be exact*) are repeat cesareans. WE NEED MORE VBACS!

Are VBACs actually safe?

VBAC is an abbreviation for Vaginal Birth After Cesarean, and contrary to many beliefs VBACs are in most cases more safe than another cesarean. A cesarean carries the risk that any major surgery would carry - risk of blood clots, infection, nerve damage, damage to other organs, etc, and this is just the list of risks to the birthing person. In comparison, a vaginal birth only carries minor risks to the birthing person like perineal or pelvic floor trauma, and in a low-risk situation there are minimal risks to baby (I want to acknowledge that in some circumstances a vaginal birth is far more risky for the baby than a cesarean. Be sure to take a prenatal class to learn which situations these might be). The only added risk that comes with VBACs is an increased risk of uterine rupture (notice how I say increased... yes a uterus can rupture even without a scar from a previous surgery!). This risk is about a 0.8 to 2% chance. If you were to make a list of all of the risks of each, the surgery's list would far outweigh the VBAC's!

A trial of labour is valuable

When a birther attempts a vaginal birth, regardless of if they are successful or not, it is called a trial of labour. When you think of what happens during a labour that is brought on naturally and is allowed to proceed even for a few hours, it makes sense why there are benefits to even trying for a VBAC. That hormone oxytocin which starts your labour and keeps it going is also responsible for the loving bond you develop with your baby and for letting down your body's milk when it comes time to feed. Additionally, natural oxytocin (the kind your own body produces, not the synthetic kind you get by the drip in a hospital) is linked to a lowered chance of postpartum mood disorders as it helps with stress and overall mental well-being. So, even a little bit of labour before a cesarean will get the natural oxytocin flowing and benefit you for years to come!

Recovery recovery recovery!

As a mom who has experienced cesarean birth personally, and a doula who has attended both cesarean and vaginal births, I know just as well as many that the recovery from cesarean birth is often quite rough. Some people luck out and feel pretty darn good pretty quick after their surgical birth, but most of us (myself included) go through months and even years of recovery to the function we were once used to. With cesarean birth, you can expect a much longer recovery process than a vaginal birth and this is due to a variety of factors. First of all, cesareans are major abdominal surgery where the OBGYN moves organs in and out of place - not just the uterus but also things like the bladder and intestines. One the surgery is complete those organs take time to find their proper place again within the body. The incision is the other part that can be more complicated. If you are fortunate to not experience any type of issue with healing the superficial portion of your scar, you will most likely still experience adhesions under the surface (more about the scar and adhesions in this post). Finally, the amount of medications like synthetic oxytocin and anesthesia that are used in surgical birth make a sizeable impact on how quick one feels "back to normal" after birth. These medications can mess with the normal hormonal dance of the postpartum period and impact your mental health which is a HUGE player in the recovery game. Overall, it's safe to assume that a recovery from cesarean will take significantly more time than a recover from a vaginal birth (with some exceptions on both ends of course).

So I'm obviously pro-VBAC, but I also understand that sometimes they aren't the safest choice and sometimes your attempts don't end up the way you plan. However, if you are a good candidate for a VBAC, even if it ends in a repeat cesarean, the attempt is a great choice for both you and your bundle. So if it's an option for you, why not explore it?!