VBAC (Vaginal Birth After Caesarean) refers to vaginal delivery in women who have previously undergone a caesarean section. According to contemporary obstetric practice and international guidelines, many women may safely achieve vaginal birth provided specific clinical criteria are met. The decision is based on the type of previous uterine incision, the overall obstetric history, and the course of the current pregnancy.
VBAC may offer advantages such as faster recovery, fewer surgical risks, and smoother postpartum adjustment. However, it requires careful candidate selection and must take place in a setting with immediate access to medical intervention, as the risk of uterine rupture — although low — remains a recognised and clinically significant consideration.
Selection Criteria
Key considerations include the type of previous uterine incision, the number of prior caesarean deliveries, the absence of additional obstetric complications, and the normal progression of the current pregnancy.
Advantages and Limitations
VBAC offers meaningful benefits but is not suitable for all women. Comprehensive counselling regarding the potential advantages and associated risks is essential to support informed and balanced decision-making.
The Role of Medical Monitoring
Close obstetric monitoring during labour is essential to ensure safety. With evidence-based guidance, individualised assessment, and a well-equipped clinical setting, vaginal birth after caesarean can be a safe and positive experience for both mother and baby.