Your VBAC Guide: Empowering You with Knowledge and Confidence

Last Updated: 7/9/24

Deciding on your childbirth plan can be a mix of excitement and nerves, especially if you’re thinking about a VBAC (Vaginal Birth After Cesarean). 

We’ve put together this guide to help you understand everything you need to know about VBACs, from the factors that make you a good candidate to the risks and considerations involved, and how pelvic health physical therapy can help during the process. 

Let’s dive in and explore your options together!

VBAC Candidacy

There are several factors to consider as you determine whether you’re a suitable candidate for VBAC:

  • Prior Uterine Incision Type: A low transverse incision from a previous C-section is preferred due to a lower risk of uterine rupture.
  • Maternal Gynecological History: Absence of prior uterine rupture. Ideally, no history of previous uterine surgery (such as fibroid removal), as this increases the risk of uterine rupture.
  • Maternal Medical History: Maternal age (generally under 40 years old), BMI, and presence of chronic conditions (diabetes, hypertension, cardiovascular disease) influence candidacy. 
  • Reason for Previous C-Section: To determine the likelihood of the same reason recurring and therefore leading to another C-section. 
  • Absence of Medical Conditions: Placental abnormalities (vasa previa, placenta previa) and large uterine fibroids may be contraindications to a vaginal delivery.
  • Pelvis Size and Baby’s Estimated Size: Adequate pelvic dimensions and the estimated size of your baby are assessed to ensure a safe vaginal delivery.
  • Mindset: Your readiness to attempt VBAC and comprehension of associated risks are essential considerations.

Benefits of a VBAC:

  • No major abdominal surgery
  • Shorter hospital stay
  • Less blood loss
  • Lower risk of infection

Risks Associated with VBAC:

  • Uterine Rupture: Though rare, uterine rupture during VBAC is very serious and can be life-threatening for both mother and baby.
  • Emergency C-Section: Labor that is not progressing, umbilical cord prolapse, or changes to fetal or maternal health may result in an unplanned C-section.

However, VBACs are successful up to 80% of the time!

Steps to Enhance VBAC Success: 

  • Maintaining a Healthy Lifestyle: Including adequate fueling, exercise, and mental healthcare. Read this blog to learn more about staying active during your pregnancy!
  • Education and Communication: Educating yourself about VBACs, addressing all questions and concerns with your healthcare provider, and advocating for yourself throughout the process.
  • Labor Support: Meeting with a pelvic floor physical therapist during pregnancy to optimize breathing, practice different laboring positions and improve pelvic floor muscle relaxation and coordination. Consider working with a doula during labor and delivery to assist in advocating for your needs and guiding you through position changes and pushing mechanics.
  • Spontaneous Labor: Opting for natural onset of labor whenever possible.

How Pelvic Health Physical Therapy Can Help

Pelvic health physical therapy plays a crucial role in both preparing for and recovering from a VBAC. 

Prior to the birth, a pelvic health therapist can help:

  • Restore mobility and sensation over the previous C-section incision site and abdomen
  • Strengthen the whole body to prepare for postpartum demands
  • Treat any pregnancy-related pain 
  • Improve the strength, relaxation, and coordination of pelvic floor muscles
  • Practice different laboring positions
  • Provide education on how to minimize vaginal tearing

After delivery, a pelvic health physical therapist can help:

  • Provide tips on immediate pain management
  • Address any potential pelvic floor dysfunction (such as weakness, pain, leaking, heaviness, or tearing)
  • Treat postpartum pain (back, wrist, hip, etc.)
  • Strengthen the core, as well as the rest of the body, to supplement the demand of postpartum tasks
  • Return you to pre-pregnancy activities

Wrapping Up: VBAC or C-Section

Choosing between VBAC and repeat C-section involves careful consideration of multiple factors, understanding of the risks and benefits, and discussion with your healthcare providers. 

At Pacer Physical Therapy, we are here to help you feel empowered and confident with your decisions, assist in coming up with a game plan, and support you throughout your perinatal journey. To learn more or work with us, book a complimentary discovery call today!

You got this!

– Vera