Updated VBAC guidelines

Here in Warwickshire and the West Midlands, we have always been very lucky when it comes to maternity services, with a wide range of options where women can choose to give birth. In more recent years, this has been particularly relevant for women who have had a previous C-Section and wanted to try to avoid another by achieving a VBAC (Vaginal Birth After Caesarean).

Typically any woman choosing to VBAC might anticipate a very medicalised experience, which could seriously undermine their chances of success. This leaves women feeling quite fearful that they might go through labour, only to end up with a C-Section anyway, so many don’t see the point in trying. Any pregnant woman who was determined to achieve a VBAC and avoid intervention, would often need extra support and would have been strongly advised to have a really good look at the policies and guidelines of her local hospitals, in order to choose one that was most willing to support her preferences, which often meant switching units and travelling a lot further.

Thanks to some excellent forward-thinking midwives, particularly at Serenity Midwife Led Unit (MLU) in Birmingham, Warwick Hospital, and more recently Lucina Birth Centre in Coventry, many women in this area have been very well supported to have a positive and more normalised VBAC, ensuring that they had the option to give birth in water and not necessarily have the usual routine actions taken like inserting a cannula with a ‘just in case’ mindset.

That said, it still takes a brave and knowledgeable woman to decide on this option for birth. She usually has to make a few calls and request meetings with senior midwives, often going against her doctor’s opinion in order to gain approval to use an MLU or similar, because it certainly isn’t something that is promoted. Stepping outside of the guidelines and being labelled as ‘against medical advice’ is a tough decision to make, so for many women, as the pregnancy develops and the due date grows near, they often lose confidence and change route.

Well hopefully, all that will change now as NICE – the National Institute for Health and Care Excellence, have just published an updated set of VBAC guidelines.

These new recommendations are for all hospitals across the country to support women planning a VBAC. They recommend all types of pain relief including the use of water. They recommend that a cannula is not used routinely, or that Continuous Fetal Monitoring (CTG) is not used as standard, opening up the possibilities for women to mobilise, which in itself makes it more likely for them to have a normal birth.

“No need for women planning a VBAC to lie on their backs on a bed anymore”

If you are pregnant and planning a VBAC, speak to your midwife about local options, and ask if you can attend a tour of any MLU’s in your area that you may not have thought available to you in the past. It may take a while for clinical guidelines in many areas to change, but you can still be confident that this national guideline will enable your local NHS trust to support your decisions.

You can read the updated guidelines here:- Nice Guidelines.