Special clinic boosts natural births after caesarean section

A clinic at the Norfolk and Norwich University Hospital dedicated to helping women have a natural birth despite having had one previous baby by caesarean section has proved a great success.

The Birth After Caesarean Section (BAC) clinic was set up at the Norwich hospital by consultant obstetrician Fran Harlow, with two specialised midwives, and is aimed at encouraging more women who have had one previous baby by C-section to go on to have a normal delivery.

The evening clinic has proved very successful. Previously only 40 per cent of women who had had a section chose to have a vaginal birth after caesarean section (VBAC) and only 64 per cent of them succeeded in doing so (November 2009 to April 2010)

But between May and December 2010 when the new BAC clinic was in place, 68 per cent of women chose to have a normal delivery and 73 per cent of them did so successfully.

Miss Harlow said: “It is important the women are allowed to make informed individual choices and if a woman does want to have another caesarean section then that’s fine. The new clinic does, however, aim to show it is possible for most women to go on to have a normal delivery despite having had one previous child by section.

“There are good reasons why having a caesarean section is necessary but it is major surgery, it can lead to complications, and it’s a more resource intensive way to give birth. Very often women are just not aware that a normal birth is possible after a caesarean and we are delighted that this service has had such a positive impact.”

The benefits of VBAC include:

• Fewer complications
• Shorter recovery time
• Greater bonding between mother and baby
• Impact on future pregnancies.

Nutritional therapist Catherine Jeans, 34, from Norwich, is one of the women who have successfully had a second baby with the help of the BAC clinic at NNUH.

Catherine had wanted to have a home birth with her first child but her daughter Lucia was an undiagnosed breech which unfortunately meant that Catherine had an emergency caesarean section.

Catherine said: “I was planning a home birth but I was rushed into hospital and had an emergency section. I had desperately wanted to have a natural birth.

“I knew I wanted to try and have a natural birth with our second baby and it was nice to have a specialist BAC clinic where they were supportive from the get go. My midwife Karen Dunlop was absolutely wonderful, very supportive and encouraging”.

Catherine went on to have a natural birth in hospital, had no pain relief, and her son Lucas was born weighing 9 lbs. Catherine also used the HypnoBirthing method and found it very helpful with her natural birth.

Catherine's husband, Mariano Cabezola, said: “Our midwife was brilliant and so supportive of our natural birth. I felt reassured that there was a specialist BAC clinic that addressed our specific needs and allowed us to have the kind of birth we wanted.”

Women attending the BAC clinic at NNUH are also being shown a DVD supporting VBAC. The short film was produced by Norwich-based Gig House Films and features a couple, Gemma and Andy. Gemma is due to have her second baby (the first was a breech baby and so was born by C-section) and really wants to have a natural birth. The DVD follows the couple through the BAC service and to the successful birth of their second child, Ruby.

• You can watch the BAC film at https://new.nnuh.nhs.uk/Media.asp?ID=36

Last year (2010/11) the total caesarean section rate at NNUH was 21.3 per cent (9.1 per cent elective and 12.2 per cent emergency). The national average was 23.8 per cent (9.3 per cent elective and 14.5 per cent emergency).