Vaginal birth after caesarean section (VBAC) is now a frequent request from women who have had to have a caesarean section in their previous pregnancy. Recognising that this is a situation that will pose a greater risk for the delivery is important for anyone contemplating a VBAC. The risks will depend on a number of factors, not least the reason for the cause of the original caesarean as well as the circumstances under which it was performed. I am broadly supportive of VBAC as I believe that it is ultimately the woman’s prerogative to decide on their delivery. To this end my role is to provide advice and guidance to allow her to come to making that decision.
Twin pregnancies are special pregnancies that require different approaches depending on the type of twin pregnancy it is. That relates to whether the twins share the same placenta or not. They need closer monitoring that singleton pregnancies with more intensive monitoring in some. Either way, twins are likely to delivery earlier although most twins are well behaved! Expect more ultrasound assessments throughout the pregnancy. The chance of requiring a caesarean delivery is higher with twins.