When a birthing client has a cesarean section and falls pregnant again, they have two choices. Another elective cesarean, or a VBAC (vaginal birth after cesarean). Both carry their own risks and benefits, but one is played up to be this huge and risky ordeal. It's no surprise that vaginal birth after cesarean (VBAC) is met with profound opposition and is often even shunned by OB's and Hospitals. If you ask your OB why this is, typically, they will say the risks of uterine rupture, placenta accreta, maternal morbidity, and infant death outweigh the benefits. Well, my lovely readers, I want to help settle some of those fears. Let's begin, shall we?!
You are probably a candidate- That's right my friend, you are probably a candidate for VBAC! Roughly, 90% of those who have had cesarean sections are a good candidate for a VBAC. Of course, there are some instances where It wouldn't be a good decision. You should have a low transverse uterine incision and not have had any prior uterine surgeries that have caused scarring. Bottom line, even ACOG says that VBAC is "safe and appropriate for most woman".
Cesarean sections are just as risky- Obviously, we all know that there are risks with cesareans. But did you know that your chances of maternal morbidity more than triples when you go into that OR (operating room). Other risksare placenta accreta, hysterectomy and blood loss - the same as VBAC. I bet your provider and hospital didn't tell you that when you were talking about your options! Still, cesarean rates are a whopping 32.8% That doesn't make much sense, does it?
Uterine Rupture- Ahhh, the go to scare tactic when discussing VBACS. Now, don't get me wrong, UR (uterine rupture) is a real worry, But it's less of a worry than you'd think. UR results in. 2% of laboring mothers with no augmentation (intervention) and 6% of that .2% end up in infant death or brain damage. That's 1 in every 26,000! Even then, lets say UR occurs, the OB and hospital staff have 15 minutes to prep you and take you in for an emergency cesarean. Despite what you may think, 15 minutes is a lot of time in the hospital world.
Before we move on to the next part of my blog, lets compare. .2% of VBAC moms end up with a uterine rupture and repeat cesareans more than triple the risk of maternal death. Which would you be more frightened of?
I also wanted to dedicate a section of this particular blog post to providers.. Why, you may ask? Because they can either make or break this decision. It is I-M-P-E-R-A-T-I-V-E to find a provider who is VBAC friendly, not just VBAC tolerant. If your provider says "Okay, we can try", "Okay, But we are going to opt for a c-section if", then they are not VBAC friendly. Find a provider who won't wheel you into the OR if you are 40+ weeks with no "progress" (what does that mean, anyway!?) Find one who isn't going to put a time limit on your birth.
You deserve to have this, if you want it (within reason, of course). I'm not saying that if there is a medical emergency to not let them do what they need to. I'm saying that you need to be supported and to be able to relax and not feel rushed. Cuz' guess what happens when you are stressed and feel rushed? You stall, clinch, and make your birth that much harder.
Another fib birthing family hears when attempting a VBAC is "we aren't equipped to handle an emergency during a VBAC." Newsflash, if a hospital has the means to handle an emergency cesarean, they have the means to handle a VBAC. It's just as simple as that.
I am not here to push you into a VBAC or cesarean. Ultimately, this is your birth and you are going to make the best decision for you and your family. There is no right or wrong way, only YOUR way. As a doula, it's my job to give you the cold, hard truth and to help educate you during this amazing time. I hope that you see VBACs in a new light and perhaps don't find them as frightening.
Looking for a doula for your VBAC or Cesarean? Contact me so that we can chat about your birth goals.