VBACs: What are the Risks, Myths, and Facts Surrounding Vaginal Births After Cesareans?

VBAC

Several years ago, having a cesarean section meant that all subsequent pregnancies would end in one as well.  The fear of complications, for both the mother and baby, made it so that women weren’t even given the option to labor and have a vaginal birth once they had gone through a c-section.  However, in today’s modern medical world we have a lot more research on this topic which strongly supports the idea that women can indeed have a vaginal birth after a c-section without an increased risk of anything happening to her or the baby.  More women than ever before are having successful VBACs (vaginal delivery after cesarean) making it a safe option for mamas.

Immediately after going through a c-section, some women know that they will try for a VBAC with their next pregnancy.  Other women know that they will undergo a repeat operation the next time around.  However, for some women the choice isn’t such an easy one.  The decision will take lots of time, consideration and research – but remember, it is yours to make based on your pregnancy and personal wishes.

What You Should Know

Statistically, 90% of women who have experienced a cesarean section, whether planned or emergency, are safely able to have a VBAC.  There is an even greater likelihood of being able to experience a safe vaginal delivery if you have had prior vaginal deliveries.  According to the American Pregnancy Association, approximately 70% of women who try for VBACs are able to have a successful vaginal delivery.  In other words, if you desire a VBAC, with the right support and encouragement, your chances are very likely that you will succeed.

Some women fear that whatever happened the first time around – whether it be that the baby was too large, pelvis too small, cord wrapped around baby causing distress, labor stalling, etc. – that caused a c-section in the first place, will occur again.  First of all it is important to remember that not all pregnancies and labor/childbirths are the same.  Also important to know is that The American College of Obstetricians and Gynecologists (ACOG) has released a statement saying that there has been no proven labor difficulties associated with having a baby larger than 8 3/4 lbs.  There is no evidence to suggest that a large baby necessitates a cesarean.  Often times changing positions frequently, keeping in an upright position or squatting can open the pelvis by up to 10%, allowing the baby room to come out.

Thanks to medical technology, the baby’s heart rate can be monitored throughout labor to ensure that fetal distress is nonexistent thus negating the reason to perform a c-section based on the baby’s health.

Recently, research has proven that VBACs can lower a woman’s risk of dangerous bleeding and infections which will lead to a less painful and shorter childbirth recovery than if she had undergone a repeat c-section.  Long term, avoiding repeat c-sections can lower a woman’s risk of having complications with future pregnancies such as: placenta abnormalities/previa, bladder or bowel issues, or the heightened risk of a hysterectomy.

What Are The Risks?

The main risk associated with VBACs is that of uterine rupture during the vaginal labor/delivery.  According to the ACOG, if you had a previous cesarean with a low transverse (horizontal) incision, the risk of uterine rupture in a vaginal delivery is .2 to 1.5%, which is approximately 1 in 500.  However, uterine rupture is not always catastrophic.  There have been times where there is no indication of rupture but the VBAC attempt ends in a repeat c-section during which a small tear is discovered.  In this case, it would be repaired with no effect what-so-ever on the baby or mother.  Another factor that can inhibit the success of a VBAC is induction.  When you are induced you are given Pitocin which often times sends your body into sudden active labor.  Pitocin induced contractions can be much harder on the uterus (and baby and mom for that matter) than natural contractions and therefore can pose a threat to scar tissue and prior incisions (from cesareans).

VBAC is safer than a repeat cesarean, and VBAC with more than one previous cesarean does not pose any increased risk. -American College of Obstetricians and Gynecologists

Who Can Have a VBAC?

The simple answer?  Almost anyone!  Women who have delivered vaginally before, or not.  Women who were told their c-section baby was “too big” or they were “too small”.  Women who’s c-section baby got “stuck”.  Women who’s labor “stalled/didn’t progress quickly enough”.  Women who had a breech baby or twins.  Women who’s c-section baby underwent fetal distress.  Do you get the idea here?  Anyone can do it!  If your current OB doesn’t support your wishes to try for a VBAC, find someone who will.  With the right support, motivation and mindset, most women can have a safe, successful VBAC.

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Interested in knowing more about pregnancy?  Check out the other posts in my pregnancy series: Where to Deliver, What’s a Doula and Midwives vs OB.  Be sure to stay tuned for my next entry: Baby Registry Must Haves!

 

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http://www.mayoclinic.org/tests-procedures/vbac/basics/definition/prc-20020457

http://americanpregnancy.org/labornbirth/vbac.html

http://www.vbac.com/making-informed-decisions-about-vbac-or-repeat-cesareans/

http://health.usnews.com/health-news/family-health/sexual-and-reproductive-health/articles/2010/07/22/vaginal-birth-after-c-section-4-factors-to-consider

http://www.acog.org

http://3.bp.blogspot.com/-TREhjh_pTEc/UKAUVXxGtoI/AAAAAAAAA4g/bc35H-U_9Pc/s1600/VBAC.jpg (picture credit)

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