Vaginal Birth after Caesarean (VBAC)

Did you have a previous caesarean? Are you exploring your options for next time around?

Here are some useful information and links to research based info to help you make decisions. 

It can be really confusing to know what your options are, what the actual 'risks' are, and how to increase your chance of getting a vbac when everything in the standard guidelines for vbac actually increases your chance of ending up with a caesarean. Everyone seems to be so focused on uterine rupture, but can it be prevented, or detected early and how do you balance the chance of that happening with the other factors. Can you have a water birth? A home birth? Do you have to have continual monitoring? Can you go to the midwife led unit? Can you give birth alone? Can you request a caesarean?

Here are some starting points. I am building this page at the moment so more will be added later. Do feel free to message me. I am always happy to help. Periodically I do vbac workshops in person or online. I did one on hbac (home birth after caesarean) which you can see for free. If you want more individual support I provide a range of doula services including being your virtual doula, face to face antenatal doula support and birth doula.  

I also post useful stuff on my Chilled Mama's Lounge, a closed facebook group.

 

Here are the vbac resources:

RCOG Green top guidelines: These are very useful because they show the level of evidence for each recommendation, and so you can see that virtually everything that is standard care for vbac is not based on much evidence, if any at all. 

Outcomes for vbac with a planned home birth or planned hospital. 56% chance of vbac with planned hopsital birth, 80% chance of vbac with planned home birth. No difference in rupture rates or admission to neonatal unit.

 

PLEASE NOTE THE LINKS BELOW MIGHT NOT WORK. I'M STILL WORKING ON THIS PAGE. (You can copy and paste into your browser.)

AIMS have lots of useful info: www.aims.org.uk  On the website you can access articles and they sell one of the best vbac books by Jenny Lesley who had a vbac after four caesareans (or vba4c). (If you like these acronyms, it was actually a hwba4c or home water birth after four caesareans.)  They also sell a great book on your birth rights: 'Am I allowed?' by researcher Pat Thomas.  Here's the link to their shop page: http://www.aims.org.uk/pubs.htm

 

This UK page is a good source of information for those recovering from a cs, planning a vbac or another cs.www.caesarean.org.uk .  I particularly like this article from amazing UK midwife Mary Cronk about signs of scar rupture.

 

This is a limited website but some great stories: http://www.vbac.co.uk/stories/

 

Some articles about vbac from Royal College of Midwivesincluding the research that you are more likely to have a successful vbac if you are under midwife led care, not consultant led care. https://www.rcm.org.uk/tags/vbac

 

Here is the NICE guideline on caesarean section which includes birth after caesarean. https://www.nice.org.uk/guidance/cg132

 

Here is the birth after caesarean guideline from the Royal College of Obstetricians and Gynaecologists https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg45/

 

As well as the AIMS VBAC book, here are some others you might like:

 

Vaginal birth after caesarean: the VBAC handboo by Helen Churchill and Wendy Savage (N.B. Wendy Savage is an senior and respected obstetrician who, back in 1982 was suspended for 'allowing' women under her care to have a home birth after caesarean. She was, of course, exonerated and reinstated. Bit of birth history for you.) https://www.amazon.co.uk/Vaginal-Birth-After-Caesarean-Handbook-ebook/dp/B004KPM33S/ref=sr_1_1?s=books&ie=UTF8&qid=1466794768&sr=1-1&keywords=vbac

 

Cut, stapled and mended by Rosanna Rosewood - a woman's journey from caesarean to vbac. https://www.amazon.co.uk/Cut-Stapled-Mended-Roanna-Rosewood/dp/1935952773/ref=sr_1_1?ie=UTF8&qid=1466795052&sr=8-1&keywords=cut+stapled+and+mended

 

The silent knife.  this is a classic text on caesareans.  https://www.amazon.co.uk/Silent-Knife-Cesarean-Prevention-Vaginal/dp/0897890272/ref=sr_1_1?s=books&ie=UTF8&qid=1466795013&sr=1-1&keywords=the+silent+knife

 

There are lots of other general birth books that will give you a good understanding of how birth works.  Just ask if you want any more.

 

This is an interesting nhs decision tool for helping you decide vbac or repeat cs.  It is interesting as it includes bladder control which doesn't often figure in women's decision making, but impact on breastfeeding, placenta fusing with scar tissue in future pregnances and other factors that are increased by a repeat cs are not included.  See what you think.  http://sdm.rightcare.nhs.uk/pda/birth-options-after-previous-caesarean/

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