If you had you gave birth to your first baby by cesarean section and consider a VBAC for your second birth, this post is for you!
Is VBAC safe?
Fist of all, you might wonder if VBAC is safe. The answer is Yes! The American College of OB/GYNs and the National Institutes of Health consider VBAC as a safe option for most women with a prior cesarean. Successful VBAC has a lot of benefits for a laboring person. The benefits include no abdominal surgery, shorter recovery period, lower risk of infection and less blood loss. VBAC is also beneficial as it prevents complications that can be caused by multiple cesareans, including bowel or bladder injury, hysterectomy and a life-threatening condition: placenta accreta.
What are the risks of a VBAC?
The most serious risk of VBAC is a risk of uterine rupture, which means a rupture of the scar from a cesarean section. However, it happens very rarely. The risk of uterine rupture for all women with a prior cesarean delivery regardless of route of delivery is 0.3%. If you give birth in the hospital and your doctor sees the risk of uterine rupture, an emergency cesarean section will be performed immediately. While uterine rupture during VBAC does entail a risk of maternal mortality, the studies show that the risk of maternal mortality is much higher for women who choose to do a repeat cesarean delivery.
If you chose to pursue a VBAC, here is a good news for you! The VBAC success rate in the US is 60-80%. Below are the steps that you can take to ensure a very high probability of your success:
Choose your provider wisely!
Above all, the main factors that will determine the success of your VBAC are the philosophy and policies of your provider. If you chose to give a birth in a hospital, I highly recommend that you inquire about successful VBAC rates in the hospital as a whole, and also for your doctor and their backup doctor.
You may also want to ask your doctor the following questions:
1) How long will they allow you to be pregnant before they suggest induction?
2) What are the reasons why they might suggest induction?
3) How long would they allow you birth naturally before they suggest cesarean?
4) How long would they let you to birth naturally after your water breaks?
Then, collect answers to these questions and do your research or contact your doula to seek advice. There are so many providers out there, and it is important to find one who aligns with your goals for birth.
Eat healthy & exercise
A healthy diet & exercise set an important foundation for a healthy pregnancy and uncomplicated birth. If you are not sure what exercise is right for you, seek advice from your doctor.
Have your team onboard!
Your birthing environment is important for your peace of mind and a healthy progression of labor. While your doula will assist you in staying peaceful throughout your labor, it is important that your partner or any other person who attends your birth also understand and respect your goals. If you feel that this is something that you need to work on, it is good for you to initiate the conversation well in advance to determine the best way they can support you in achieving your goals. Ultimately, it is vital for everyone present at your birth to be supportive of your decisions.
Jen Kamel, ‘Too Bad We Can’t Just “Ban” Accreta-The Downstream Consequences of VBAC Bans’, Science & Sensibility, available at: https://www.scienceandsensibility.org/p/bl/et/blogid=2&blogaid=735
Janelle Komorowski, ‘A Woman’s Guide to VBAC: Putting Uterine Rupture into Perspective’, Giving Birth with Confidence, available at: https://www.givingbirthwithconfidence.org/p/bl/et/blogid=16&blogaid=181
Guise J-M, Eden K, Emeis C, Denman MA, Marshall N, Fu R, Janik R, Nygren P, Walker M, McDonagh M. Vaginal Birth After Cesarean: New Insights. Evidence Report/Technology Assessment No.191. (Prepared by the Oregon Health & Science University Evidence-based Practice Center under Contract No. 290-2007-10057-I). AHRQ Publication No. 10-E003. Rockville, MD: Agency for Healthcare Research and Quality. March 2010, available at: https://www.ahrq.gov/downloads/pub/evidence/pdf/vbacup/vbacup.pdf
The American College of Obstetricians and Gynecologists’Vaginal Birth After Cesarean Delivery’, December 2017, available at: https://www.acog.org/Patients/FAQs/Vaginal-Birth-After-Cesarean-Delivery