Yes, You Can Have a Safe Vaginal Birth After a C-Section

Virginal Birth After Caesarean Section (VBACS) refers to the successful vaginal delivery of a baby after a previous cesarean section birth. This type of birth is surrounded by a significant lack of information and misinformation. This automatically means that for many Kenyan women, the decision to have a vaginal birth after a cesarean is either not an option at all, or is met by uttermost fear, confusion, and limited information. Cultural narratives, hospital policies, and misinformation have made it difficult for women to make informed choices about their childbirth options.

For years, the medical community believed “once a C-section, always a C-section.” In fact, through my coming of age, what I have been told is that once a lady has a child via Cs, particularly the first child, this automatically means that they would always deliver through Cs in the case of future deliveries.

I know of two women who were asked by the doctors to go for elective Cs a few days before the EDD lest they get into labor, as that could risk both their lives and that of their baby.

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However, modern research and practice have proven that this does not have to be the case and many women can safely give birth vaginally even after one or two previous cesareans. provided they were low-transverse cesareans. However, despite the improvement in modern medicine, VBACs still require caution, and their safety is highly dependent on multiple other factors such as:

• The type of incision made during your previous C-section
• The reason for your previous C-section
• The time between pregnancies
• Your overall health and pregnancy progress
• Access to emergency care in case a C-section becomes necessary

In the case that VBAC is exercised on unqualified candidates, it poses the risk of patients suffering from the fatal risk of uterine rupture—a serious complication where the scar from the previous cesarean tears open during labor.

That explains why it’s essential to plan your VBAC in a facility equipped to handle emergencies. Because of this reason, it is unfortunate that here in Kenya, VBACs remain very rare, particularly in public hospitals, which may not be fully equipped to deal with the acute complications that may arise from this form of delivery. Doctors prefer repeat cesareans due to perceived convenience, fear of legal liability, or outdated protocols. Additionally, since VDACs are surrounded by an extreme lack of information, many women are not even informed of the option and are instead automatically scheduled for elective C-sections.

Luckily, more private maternity care centers in Nairobi are now becoming more open to VBACs as they are more equipped and have more highly trained practitioners who can handle high-risk birthing procedures. Even better, modern and empowered women are doing their research enough to know that VBACs are an option that challenges the medical fraternity to change the narrative.