TOLAC, or trial of labor after cesarean, is a procedure that allows women who have previously had a cesarean delivery to attempt a vaginal delivery for their subsequent pregnancies.
When a patient visits us for TOLAC, we conduct counseling and provide all the necessary support to them. Different parameters are considered to determine whether the patient is eligible for TOLAC. Once selected, we handhold them all along until they deliver. We have had a success rate of 66%.
Successful TOLAC is called VBAC and is usually interchangeable. Our center has water birth as well and we have extended this to TOLAC.
We have now started offering VBA2C (i.e Vaginal Birth after 2 Cesarean)
We are one of the only few centers in the world to offer VBAC under water, also called WaterVBAC.
FAQ
- It is physiological
- It avoids the complications related to surgery like complications of anaesthesia, injury to surrounding organs, more blood loss, risk.of infection, abnormal placentation in subsequent pregnancies, which can be life threatening.
- VBAC leads better lactation success, better bonding between mother and baby in the initial few days ,and shorter hospital stay.
- It empowers the mother that she is capable of vaginal birth in spite of a.previous CSection.
Perineal trauma in the form of episiotomy, or tears
We will have to resort to an emergency Caesarean Section.
80% of mums with previous 1 Caesarean can be candidates for VBAC, out of which 75% can safely deliver vaginally.
Single baby, not a short mother {passage},not a large baby{passenger}, spontaneous onset of labour, no medical or surgical complications, previous one Caesarean Section only.
Any facility which can monitor the mother and her unborn baby for continuous well being.
Any facility where a Caesarean can be undertaken in reasonable time if the trial of scar has to be abandoned and baby to be delivered by repeat Caesarean .
Any practitioner who is knowledgeable about the physiology of labour, experienced in both vaginal births and Caesrean Sections who have the time and empathy to give this option to mothers.
Your chance of Caesarean are more than if you had a previous normal vaginal delivery, be prepared for repeat surgery, if you deliver vaginally, take it as a bonus.
Yes, weight of the fetus can be controlled by avoiding fatty, sweet food, walk for 15 minutes after every meal to ensure baby does not grow very big.
May be, if done by a reliable ultrasonologist. Can be done at term, 4mm and more scar thickness denotes scar integrity.
Not strictly necessary. Many women go into labour before scar thickness have been measured and successfully deliver vaginally safely.
The longer the interval, the better, minimum 18 months recommended.
Spontaneous onset of labour, a good cervical score at admission, a reassuring fetal heart recording, have the best TOLAC outcomes.
Post term pregnancy, meconium staining of liquor at admission, and prolonged active phase of labour reduce the chances of VBAC.
- Control weight gain in pregnancy by: split breakfast one and a half hours apart, walk for at least fifteen minutes after every meal and avoid high calorie meals.
- Education about childbirth and what to expect.
- Identify obstetricians who will promote and support TOLAC.
It’s the practising obstetrician’s perception of the risks involved with TOLAC. If the doctor is exposed to challenging vaginal deliveries during the training period and gained experience of looking after TOLACs, he/she is comfortable with TOLAC and VBAC, and does not associate these with “high risk”.
Gallery
Stories from Our Patients
We are blessed to have met Dr Fathima mam. My first delivery was a C-section inspite of hiring a dedicated yoga trainer food and care etc. We were desperately looking for VBAC and for a doctor whom we can trust.
Mam was very experienced and handled my case with very good care and expertise. A divine entity, Fathima mam is in the form of a human to help change the way society considers and treats the delivery process.
I had a successful VBAC water birth and we are happy to have experienced this without much hassle which usually you see in any private hospital. I started having pains in the early morning 3, and got admitted to the hospital within an hour. Though there was an emergency, mam took care of me every hour and she and her wonderful staff were there with me throughout delivery.
A Pediatrician was available for my baby to avoid any complications. I was discharged on the second day with minimal medicines and scans but with a big contentment in my heart. Thank you, mam. I recommend it to any lady who wants to enjoy the delivery process to this hospital.
Trust her and be relaxed.
Amukhta (Jun 2023)
🌸 Blessed with a Baby Girl! Zainab Amaz 🌸
Words cannot express the immense joy and gratitude we feel as we announce the arrival of our precious baby girl Zainab Amaz into our lives. It is an overwhelming moment of pure happiness and love. 💖✨
We would like to extend our heartfelt thanks to Dr. Fathima and her incredible team for their dedicated support throughout this beautiful journey. Dr. Fathima, you are truly a gem! 🌟
From the moment we met Dr. Fathima, we knew we were in good hands. Her professionalism, expertise, and compassion were evident in every interaction. She went above and beyond, answering our calls even in the late hours of the night, showing unwavering attentiveness and care. We are truly grateful for her dedication and commitment.
We have always believed in allowing nature to take its own course, which is why we chose the path of a water birth. Little did we know that this decision would be coupled with the challenge of a VBAC (Vaginal Birth After Cesarean). However, with the unwavering support of the incredible Dr. Fathima, we embraced this unique journey and achieved our dream of a safe and natural water birth.
Choosing a water birth after a c-section VBAC required trust, courage, and the right support system. Dr. Fathima not only provided us with exceptional medical care, but she also fostered an environment of empathy and understanding. She respected our wishes and nurtured our belief in the power of nature. With her guidance, we were able to witness the miracle of life in the most beautiful and natural way possible.
We would also like to express our sincere appreciation to her entire staff. Their warmth, kindness, and support made our experience even more memorable. Each member of the team played a crucial role in ensuring the best possible care and comfort during the water birthing and VBAC process. We are forever grateful for their efforts.
Today, as we hold our precious baby girl in our arms, we are in awe of the wonders of nature and the incredible journey we embarked upon.
To all the expectant parents out there, we highly recommend Dr. Fathima and her team for their exceptional care and expertise. They have made our journey towards parenthood an incredible one, and we are filled with nothing but gratitude.
Thank you, Dr. Fathima, and your amazing team, for being there for us every step of the way. We will forever cherish this beautiful experience and the precious gift of our baby girl Zainab Amaz
With profound gratitude!
Amaz Ayaz & Fariya Amaz (June 2023)
I vouch!! I endorse!! Dr. Fatima Poonawala. Just not for the delivery she did for us, but her brutal honesty & professionalism.
1st delivery was C-sec reason- cord around neck.
3yrs later conceived, for first 4months it was hell, as doc made to take scan&blood test every week. Only after 4 months doc confirmed 2nd pregnancy. At that point itself doc confirmed C section for 2nd delivery for only reason that 1st delivery was C section.
Also to mention ectopic between 1st delivery and 2nd pregnancy.We didn’t wanted C section for the 2nd time for simple reason, not ready to take medication & it takes 6months to recover completely.
We knew about this doc at 6th month thru friend who had her 3rd delivery as normal after 2 C sec. Our friend just said to go blindly with this doc, as this doc will say YES or NO. If it’s YES then just leave everything to her. As we were not from Bangalore, we had to travel twice for check up. She said we can give it a try and did not confirm normal delivery, but asked to keep posted on the sugar and BP level.
We followed her instructions. Just before a week of delivery, doc was worried about the wellness of 1st delivery stitches, she asked us to take a scan from our hometown. Seeing the scan report taken at our hometown, she refused for normal delivery and asked us to do a planned C section within 2 days. We left with no words, asked her can we repeat the same scan with her. Upon us insisting, she referred for second scan to her trusted doc. The 2nd scan said the stitches completely fine and go for normal delivery without any fear.
That’s how I understood how some hospital docs and scan centers are running a scam with people life.
After seeing 2nd scan report, Dr. Fatima, asked us to take a hotel and stay until pain comes normal delivery. Even we requested 10 times for a hospital ward room, she refused giving one- which showed she is not a commercial doc.
After stay of 4days, when wife got pain 2days prior to delivery, doc did not admit us but asked wife to just climb hotel steps and keep doing physical work. We were shocked.
One days before delivery, when wife couldn’t bare pain, doc said cervix has not opened completely so to keep walking and did not admit us. We were frustrated and irritated. But the reason she gave was for not admitting us was very valid for not admitting us. She said if wife got admitted there might be a chance of unnecessary medication which she did not wanted on her patients which was wise and correct.
She admitted us just 4hours before the delivery and delivered us a beautiful baby in normal method without even a small medication and my wife came walking from labour room with baby to the ward. Doc discharged us next evening and said we can travel back to hometown. Wife is perfectly doing all work and baby is completely fine. No medication and nothing.
Thus, I just believed her and had faith and patience in ourselves which indeed made us write this review.
Mukund Rao
First of all thanks to Dr Fatima from the bottom of our hearts for guiding us through VBA2C. Nobody gave us any chance and we were preparing for third C section. Our only hope we knew was to consult Dr Fatima. Earlier during 2nd pregnancy also we consulted her but we could not travel to Bangalore because of death of my mother around the time of delivery. So we had 2nd C section.
But this time around we consulted her and she advised to come by 20th Feb.We travelled by Car from Goa to Bangalore on 19 Feb. All the tests were done and by grace of almighty all the results were good and we were waiting for the big day. On 23 morning 6.30 am my wife’s water broke so we admitted her to Alfa Clinic. Initially there were no labour pains but Dr Fatima gave us confidence that it would start after 12 hours and she would wait till 48 hours before doing C section. So we waited very anxiously and finally by evening there were regular pains and around 2.00 am in the morning my wife delivered normally. We were overjoyed finally. Dr Fatima and her support staff all took great care of us and never did we feel we were away from home in a different city. I would recommend anybody who wants to try VBAC please visit Alfa Clinic. Rest assured you are in safe hands.
Mumtazul Hassan Piyada
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