Why it’s done
While VBAC is associated with fewer complications than an elective repeat C-section, a failed trial of labour after caesarean (failed TOLAC) is associated with more complications, including, rarely, a uterine rupture. If your uterus tears open during labour, an emergency C-section is needed to prevent life-threatening complications, such as heavy bleeding for the mother. If the rupture is complex or to stop the bleeding, the uterus might need to be removed (hysterectomy). If your uterus is removed, you won’t be able to get pregnant again.
How you prepare
If you’ve previously had a C-section and you’re pregnant, you might begin talking about VBAC at your first prenatal visit. Discuss your concerns and expectations with your health care provider. Make sure he or she has your complete medical history, including records of your previous C-section and any other uterine procedures. Your health care provider might use your medical history to calculate the likelihood that you’ll have a successful VBAC. It’s important to continue discussing the risks and benefits of VBAC throughout pregnancy, especially if certain risk factors arise.
If you choose a VBAC, boost your odds of a positive experience:
• Learn about VBAC. Take a childbirth class on VBAC.
• Plan to deliver the baby at a well-equipped hospital. Look for a facility that’s equipped to handle an emergency C-section.
• Allow labour to begin naturally, if you can. Having labour induced or augmented decreases the likelihood of VBAC.
• Be flexible. Some complications of pregnancy or labour might require a C-section. For example, you might need a C-section if there’s a problem with the placenta or umbilical cord, your baby is in an abnormal position, or your labour fails to progress.