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VBAC Counseling in Bhubaneswar

Many women who have had a previous caesarean section are suitable candidates for a vaginal birth in a subsequent pregnancy. Vaginal Birth After Caesarean, commonly referred to as VBAC, is a safe and achievable option for carefully selected women when managed by an experienced specialist in a well-equipped facility.

At Rahat Hospital  in Bhubaneswar, Dr. Reshma Krishna Priya provides structured VBAC counseling, thorough clinical evaluation, and closely monitored delivery support for women considering this option. With an DNB in Obstetrics and Gynaecology, Dr. Reshma has the specialist expertise to assess VBAC suitability accurately and support women through every stage of the process with honesty and confidence.

Comprehensive VBAC Evaluation and Counseling

VBAC is not a decision that should be made without a thorough clinical assessment. At Rahat Hospital, Dr. Reshma conducts a structured VBAC evaluation that covers the mother’s full obstetric history, the nature of the previous caesarean, the current pregnancy, and the specific risks and benefits that apply to each individual patient.

The goal of VBAC counseling at Rahat Hospital is not to encourage or discourage vaginal birth. It is to give every woman the accurate, complete information she needs to make a fully informed decision in partnership with her specialist.

The evaluation covers:

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Review of previous caesarean records including indication, type of uterine incision, and any intraoperative complications
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Assessment of the interpregnancy interval and uterine scar healing
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Discussion of the risks of uterine rupture, emergency caesarean, and maternal and neonatal outcomes
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Clinical assessment of the current pregnancy including fetal size, position, and placental location
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Calculation of individual VBAC success probability based on validated scoring tools
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Clear explanation of what a Trial of Labour After Caesarean (TOLAC) involves and what to expect during labour

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Medical Factors Considered for VBAC

Not every woman with a previous caesarean is a suitable candidate for VBAC. Dr. Reshma assesses each case individually against the following clinical criteria:

Factors That Support VBAC Candidacy

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One previous lower segment caesarean section with a transverse uterine incision
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Spontaneous onset of labour or controlled induction where appropriate
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Normal fetal size and position at term
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No contraindication to vaginal delivery in the current pregnancy
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Previous successful vaginal delivery, including a previous VBAC
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Adequate interpregnancy interval of at least 18 to 24 months
Factors That May Contraindicate VBAC
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Multiple previous caesarean sections depending on individual risk assessment
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Medical conditions requiring planned delivery before the onset of labour
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Large for gestational age baby with cephalopelvic disproportion
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Previous classical (vertical) or T-shaped uterine incision
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Previous uterine rupture
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Placenta praevia or low-lying placenta

Dr. Reshma provides an honest assessment of where each patient stands against these criteria. Where VBAC is not considered appropriate, the reasons are explained clearly and a planned repeat caesarean is discussed in full detail.

VBAC Pregnancy Monitoring and Delivery Planning

Women pursuing VBAC at Rahat Hospital receive the same standard of specialist pregnancy care with a structured antenatal monitoring plan tailored to the specific risks associated with Trial of Labour After Caesarean.

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Antenatal Monitoring

  • Serial growth scans to monitor fetal size and ensure the baby remains appropriate for vaginal delivery
  • Uterine scar assessment by ultrasound to evaluate lower uterine segment thickness and scar integrity
  • Regular blood pressure, urine, and haemoglobin monitoring
  • CTG as required in the third trimester
  • Detailed birth preference discussion at 36 weeks including VBAC plan and emergency caesarean protocol
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Intrapartum Care During TOLAC

  • Continuous CTG monitoring throughout active labour to detect early signs of fetal distress or uterine scar compromise
  • Regular clinical assessment of uterine scar site during labour
  • IV access maintained throughout labour for immediate intervention if required
  • Anaesthetic team on standby for emergency caesarean if needed
  • Neonatal team informed and available at the time of delivery
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Emergency Caesarean Backup

VBAC is only undertaken at Rahat Hospital because the facility has the full infrastructure to perform an emergency caesarean within minutes if required. Dr. Reshma does not offer TOLAC in settings where this backup cannot be guaranteed. This is a non-negotiable safety requirement for every VBAC delivery at Rahat Hospital.

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Our Approach and Procedure

Step 1 — Initial VBAC Consultation

Dr. Reshma reviews all previous caesarean records, the current pregnancy details, and the patient’s personal preferences. A preliminary assessment of VBAC suitability is made and the counseling process begins.

Step 2 — Clinical Evaluation and Risk Scoring

A formal VBAC suitability assessment is completed using validated clinical criteria. Individual risk and success probability are calculated and discussed transparently with the patient.

Step 3 — Structured Antenatal Monitoring Plan

 An individualised monitoring schedule is established covering growth scans, scar assessment, and third trimester surveillance — following the same protocols used in high-risk pregnancy care to ensure both mother and baby remain suitable for VBAC as the pregnancy progresses.

Step 4 — Birth Plan Discussion at 36 Weeks

A detailed birth plan is established at 36 weeks covering the VBAC plan, signs that would necessitate a switch to caesarean, patient preferences during labour, and neonatal readiness.

Step 5 — Monitored Labour and Delivery

Labour is conducted under continuous monitoring with anaesthetic and neonatal support immediately available. If at any stage labour is not progressing safely, the decision to move to emergency caesarean is made promptly and without delay.

Why Choose Rahat Hospital for VBAC Counseling in Bhubaneswar?

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Specialist with Fellowship in Fetal Medicine

Dr. Reshma’s post-DNB Fellowship in Fetal Medicine provides advanced expertise in obstetric risk assessment, uterine evaluation, and intrapartum management that is directly relevant to VBAC cases.
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Honest, Evidence-Based Counseling

VBAC counseling at Rahat Hospital is guided by clinical evidence and individual risk assessment, not by institutional preference for one mode of delivery over another. Dr. Reshma gives every patient a balanced, complete picture.

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Full Emergency Caesarean Capability On-Site

Rahat Hospital has the surgical team, anaesthetic support, and operating infrastructure to perform an emergency caesarean immediately during labour. TOLAC is never offered without this backup in place.
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Level III NICU Within the Same Building

 Rahat Hospital’s Level III NICU ensures that newborns requiring immediate care after a VBAC delivery can be attended to within minutes by our neonatal team

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Continuity of Care with One Specialist

Dr. Reshma personally manages every VBAC patient from the initial counseling consultation through to delivery. Patients are not passed between multiple doctors at different stages of their care.

FAQs

Q1: Is VBAC safe?

VBAC is safe for carefully selected women when managed by an experienced specialist in a facility with emergency caesarean capability on-site. At Rahat Hospital, VBAC is offered only when both clinical criteria and facility requirements are met.

Q2: What is the success rate of VBAC?

Success rates for VBAC in suitable candidates range from 60 to 80 percent. Individual probability depends on factors including the reason for the previous caesarean, interpregnancy interval, fetal size, and onset of labour.

Q3: What is the risk of uterine rupture during VBAC?

The risk of uterine rupture during TOLAC is approximately 0.5 to 1 percent in women with a single previous lower segment caesarean. This risk is assessed individually and discussed in detail during the VBAC counseling session.

Q4: Can I have VBAC if I have had two previous caesarean sections?

This depends on individual clinical factors and is assessed case by case. Dr. Reshma reviews all relevant history before making a recommendation.

Q5: What happens if VBAC does not progress safely during labour?

If any signs of fetal distress, scar compromise, or labour failure are detected, an emergency caesarean is performed immediately. The anaesthetic and surgical team are on standby throughout every TOLAC at Rahat Hospital.