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VBAC at Nadezhda: Katrin and Baby Oliver
On 7 May, baby Oliver was born at Nadezhda Hospital through a vaginal birth. He is the second child of Katrin, who delivered his older sister Sofia by emergency Caesarean section in 2021.
12.05.2025 | 11:57
On 7 May, at 4:50 PM, baby Oliver entered the world in the delivery suite of Nadezhda Hospital. He was born with perfect measurements – 50 cm and 2,960 g – under the care of Dr. Iliana Buteva-Hristova and midwife Nadezhda Stamenova. The anaesthesiologist attending the birth was Dr. Vladimir Daskalov, while neonatal care was provided by Dr. Valentina Tomova.
Oliver is the second child of Katrin Ruus. In 2021, Katrin welcomed her daughter Sofia at Nadezhda Hospital via emergency Caesarean section. Four years later, she gave birth to her son through a successful vaginal birth after Caesarean (VBAC).
VBAC is not new to Nadezhda’s practice, but we believe that sharing positive stories like this one can encourage more expectant mothers who are eligible candidates but may still feel uncertain about attempting a vaginal birth after a previous Caesarean section.
The day after Oliver’s birth, we met with Katrin to talk about her motivation for choosing VBAC, the people who supported her throughout the journey, her recovery, and the message she would like to share with other mothers.
1. Tell us a little about yourself and your family.
My name is Katrin. I have a four-year-old daughter who was also born at Nadezhda Hospital. One thing that makes our family a little different is that my husband is English, although we live in Bulgaria. And just one day ago, Oliver was born, so our family has grown from three to four.
2. How did you come to Nadezhda Hospital?
Before I became familiar with Nadezhda Hospital, I already knew Dr. Iliana Buteva-Hristova. She supported me throughout the years before I had my children, and since she is part of the Nadezhda team, this is where I chose to give birth – because of my favourite doctor.
3. What led you to choose VBAC, and did you feel supported in your decision?
In Bulgaria, there is a widespread belief that once you have had a Caesarean section, every subsequent birth must also be by Caesarean. Interestingly, I think this perception exists mainly here. In many other countries, VBAC is simply considered part of normal maternity care.
I am very happy that Nadezhda Hospital supported my decision to pursue a VBAC. More importantly, we carefully discussed and assessed all potential risks in my particular case. The truth is that even when a woman strongly wants a VBAC, circumstances may arise that make another Caesarean necessary. However, if there are no medical contraindications following a previous Caesarean and the uterus has healed well, I see no reason why a woman should not try for a vaginal birth.
I was fully aware that something could develop during pregnancy that might indicate the need for surgical delivery. Fortunately, everything followed the original VBAC plan. Dr. Iliana Buteva-Hristova was incredibly supportive and constantly reminded me that my motivation was essential.
The truth is that success depends not only on the patient’s motivation but also on whether the medical team stands behind her decision. I will admit that I occasionally had doubts myself, but the support from the hospital team was exceptional, and in the end, everything worked out.
My first birth had also been planned as a vaginal delivery, but it ended in an emergency Caesarean section. The same team was with me then – Dr. Hristova and midwife Stamenova. Everything started well, but my daughter never descended into the pelvis, and an emergency Caesarean became necessary. At the time, that outcome was difficult for me because I had not prepared for it. This time, I knew that anything could happen, and I felt much calmer.
I clearly remember that during my postpartum check-up after the first birth, Dr. Hristova told me: “Your uterus has healed very well, so when you decide to have another child, you can try for a vaginal birth.” Since then, I had been considering the possibility of a physiological birth, and I am delighted that it became a reality.
4. How did the birth itself unfold?
Oliver’s birth was so quick that compared to his sister’s, it felt like a walk in the park. A VBAC birth must begin spontaneously; labour cannot be induced. A few days before delivery, I experienced strong contractions, but they were not sufficient for active labour. Those days were challenging because I made several trips to the hospital thinking labour had begun.
When I arrived at the hospital on 7 May, I was already 6 cm dilated. I was admitted for examination at around 2:00 PM, transferred to the delivery suite shortly before 3:00 PM, and just two hours later Oliver was born.
Because it was a VBAC, I had imagined labour would last at least seven or eight hours. When midwife Nadezhda Stamenova said, “Come on, it’s time to push, your baby is coming,” I was genuinely surprised because I thought I still had at least two more hours to go.
Everything happened very quickly. The team was wonderful. Dr. Iliana Buteva-Hristova and midwife Nadezhda Stamenova worked like a perfectly synchronised machine. It seemed as though they communicated with a single glance and everything unfolded exactly as if it had been planned in advance. I had never witnessed such teamwork before.
Their partnership was extraordinary and made it possible for a VBAC baby to be born in such a short time. I do not know how often that happens, but for me it was phenomenal. My husband, who was present at the birth, was equally amazed that the entire process was completed within two hours.
5. Based on your experience, how does recovery differ between a Caesarean section and a vaginal birth?
Recovery after a Caesarean section is unquestionably more difficult. Of course, there is some discomfort after a vaginal birth as well, but within half an hour you are already moving around, eating, holding your baby, and caring for them. There is no comparison.
A Caesarean is major surgery and requires recovery time in intensive care. The two experiences are fundamentally different.
I remember how it was after my Caesarean. My body reacted differently. I struggled with mobility, I could not hold my baby comfortably, and for the first couple of days I was unable to care for her the way I wanted to.
6. How did little Sofia react to becoming a big sister?
I think Sofia is still processing everything. She had been eagerly awaiting the baby’s arrival. In the days before the birth, we visited the hospital frequently, and she kept asking, “Do we have the baby yet? Where is the baby?”
Yesterday, when she finally met him, she was amazed to see him in person. She promised me that she would take very good care of him. In fact, the very first thing she said was that she was going to tickle him.
7. What would you say to women who are considering a vaginal birth after a previous Caesarean section?
I had fears and doubts too. I think women considering VBAC need to accept that events may not unfold exactly according to plan. That mindset makes the decision much calmer, more informed, and easier.
I would encourage women to talk to their doctors about VBAC and, if they are suitable candidates, to give it a try. The belief that once you have had a Caesarean you must always have a Caesarean often exists in the minds of expectant mothers themselves, preventing them from even asking the question.
Yet sometimes, simply starting the conversation can lead to a completely different outcome. Asking about VBAC is often the first step toward a successful vaginal birth after Caesarean—a truly priceless experience.
