Vaginal Birth after Cesarean
  • uterine rupture
  • hysterectomy
  • perinatal morbidity including cerebral palsy and fetal or neonatal death (Dauphinee, 2004)

    VBACS are only appropriate:

  • for women who have had a previous Cesarean section with a low transverse incision (bikini cut incision)
  • when the previous Cesarean section was 24 months ago or longer
  • if the hospital is a tertiary care center with access to do an emergency Cesarean if needed within 30 minutes from decision to incision
  • mother has been fully informed of the risks

If the VBAC takes place in a tertiary care center where an emergency Cesarean can take place within 30 minutes from decision to incision the rate of perinatal morbidity is very low(Dauphinee, 2004)

Elective Repeat Cesarean Section
  • baby may be born early if dates are wrong
  • baby is not exposed to hormones that are produced during labour
  • increased chance of baby being admitted to the Neonatal intensive care unit for breathing problems
  • more likely to have a lower Apgar score
  • unable to be with baby immediately after delivery as mother spends time in recovery room
  • decreased chance of breastfeeding
  • longer recovery time
  • increased postpartum pain(Goer, 2001)
  • longer hospital stay
  • more expensive
  • increased incidence of infection
  • increased incidence of damage to internal organs
  • increased chance of placenta previa with subsequent pregnancies
  • increased scar tissue in abdomen due to surgery(Dodd & Crowther, 2004)
  • increased maternal mortality, women are more likely to die if they had a cesarean vs. vaginal birth (Goer, 2001)

References