“VBAC” is an acronym for vaginal birth after cesarean. Other variations of this acronym may be used to describe more specific birth situations, such as HBAC (home birth after cesarean), or VBA2C (vaginal birth after two cesareans).
If you have not already had an epidural or spinal anesthesia for labor, or this is a scheduled cesarean, you will most likely be given a regional anesthetic (epidural or spinal). If there is a reason that you can’t get regional anesthesia or it is an emergency you may be given a general anesthetic. You also may be offered a pre-operative sedative, and the surgical consent form may say this is a possibility. In family centered cesareans, sedatives are typically not offered, as it can make it more difficult to be alert and present during your birth. After the birth, you may have the option of IV or oral pain medications, which you should discuss with your provider.
This is not a comprehensive list.
Obstetrical emergencies like:
-prolapsed cord (where the cord comes down before the baby)
-placental abruption (where the placenta separates before the birth)
-placenta previa (where the placenta partially or completely covers the cervix)
-placenta accreta (where the placenta is too deeply embedded in the uterine wall and has potential for maternal hemorrhage)
-eclampsia/pre-eclampsia (pregnancy-induced high blood pressure, causes severe swelling due to water retention, and can impair kidney and liver function. If it progresses to eclampsia, toxemia is potentially fatal for mother and child.)
Other common reasons we hear for cesarean are:
-fetal malpresentation such as transverse lie or breech (many are not given a full range of options such as vaginal breech birth with a skilled provider or external cephalic version to turn a malpositioned baby)
-suspected cephalopelvic disproportion aka CPD – (meaning that the head is too large to fit through the pelvis. Actual condition is very rare. This is often over diagnosed, and many women do go on to have vaginal births after a cesarean for CPD)
-Maternal medical conditions (active herpes lesion, severe hypertension, diabetes, etc.)
-fetal distress. (This is a hot topic with the recent studies indicating that continuous electronic fetal monitoring increases the cesarean rate and does not show a relative increase in better outcomes. Discuss with your care provider how they define fetal distress and what steps are used to remedy the situation before a cesarean.)