- Women's Health»
VBAC - vaginal birth after Cesarean
VBAC or Vaginal birth after Cesarean delivery is an option that more and more mothers are looking into. The information contained in this hub will summarize some of the characteristics and statistics for those pursuing VBAC. Proper guidance from your physician (OB Gyn) or nurse midwife is needed.
You might be told that you are not a suitable candidate for VBAC for a myriad of reasons or you might live in a state where the option is not offered and you must pursue another Cesarean section delivery (C section) if you are pregnant.
In the United States today, various sources show that over 33% or 1/3 of all human births are performed via Cesarean section.
This percentile was once much lower but has been increasing over the years. There are many speculations for why this might be the case. Some opponents to this increasing number speak of the "cascade of interventions" including the administering of pain alleviating drugs such as epidurals which might cause labor to stall and cause fetal distress. Talk show host, actress and entertainer Ricki Lake speaks on some of these issues in her documentary film The Business of Being Born.
There are people at both sides of the fence on this issue. Many are strong proponents and advocates for the often lifesaving use of C section deliveries and many individuals believe that C sections are overused by the medical community.
Cesarean sections are a major form of surgery in which a cut is made through the skin often at the bikini line to access the internal womb or uterus. An additional incision is made on the uterus to pull the baby out of the womb. This form of surgery was developed over 2,000 years ago. The first baby said to have been born via this method was Alexander the Great.
It must be acknowledged that whatever the reason for the intervention, Cesarean sections have been life saving for countless mothers and babies through history.
While many babies are born via Cesarean section and many mothers even request elective Cesarean section before having to encounter an unplanned or emergency one, there are still some mothers who steadfastly seek to avoid the surgery when birthing their babies.
According to the various sources including WebMD, 92% of women who for whatever reason have had previous Cesarean or C sections (for the 1st child) will have another C section for each subsequent child. There was a time when this was required by medical providers but women now have the option in many parts of the country.
For the 8% of women who will be interested in having a VBAC or Vaginal Birth After Cesarean, they must look for VBAC supporting health providers. There are various pros to pursuing VBAC including faster recovery time from childbirth. A woman needs 6 to 8 weeks to recover from a C section and less time to recover from vaginal birth if there are no complications such as significant tears.
Women looking to pursue VBAC must be informed patients. They will likely be told about the VBAC predictor/caculator by their physician - obstetrician/gynecologist (OBGyn) or nurse midwife.
Whether or not a woman will be able to pursue VBAC depends on that individual woman and the odds that can be stacked by her risk factors.
Age, race or ethnicity all play a factor. African American women and older women are typically told that they are at higher risk of being unable to pursue VBAC without complications.
It must be noted that women at the age of 35 or older are considered of advanced maternal age. The older they get beyond this age, the more their fertility decreases and if they do get pregnant, have C-sections and then pursue VBACs, they might be discouraged from doing so depending on their medical providers.
Additionally, a woman is considered high risk for pursuing VBAC if she is obese or morbidly obese, has gestational diabetes, high blood pressure or preeclampsia for example.
Advice for pursuing VBAC
If you are pursuing VBAC, check an online physician and nurse midwife directory or the yellow pages for your area. Look at magazines, newsletters and general free publications for women. These can easily be found at the entrance of your supermarket for example.
Physician and midwifery practices often purchase ads in these types of publications geared toward pregnancy, mothers, parents, parenting for example.
You might want to look for an ad of a practice that markets their support of VBAC, read reviews and/or get recommendations from people you know.
Physicians and midwives often work in collaboration for women's health at joint practices.
Nurse midwives are often proponents and advocates for women to pursue natural childbirth.
They are however unable to perform surgery so they can either work with very low risk patients (who have no serious health conditions) or they can have obstetrician/gynecologists on standby in the event that emergency or unplanned C section must be performed.
Most medical providers support hospital births over home births for this and many other reasons.
When a woman pursues VBAC, she must have an open mind and accept that she might be allowed just a trial of labor to see how her body will react to uterine contractions.
If the contractions are too strong for the uterus to withstand, there can potentially be a uterine rupture linked to the scar tissue on the uterus from the previous C-section.
Please do not approach the idea of VBAC with a fear of this scenario. Statistics show that uterine rupture currently occurs in 1% or less of women pursuing VBAC.
You might think that your medical provider is instilling fear in you when he or she discusses the possibility of uterine rupture but it is only to make you more fully informed of all the possible risks involved.
Albeit rare, uterine ruptures can occur and it would be important for you to know that. Uterine ruptures can be repaired in most cases or in other cases they can require emergency hysterectemy. It runs the gamut.
Childbirth - VBAC Trial of Labor
When approaching a trial of labor, you will be encouraged to prepare for the most gentle labor possible whether or not you choose to have pain relieving drugs.
Childbirth is very taxing on the body and contractions are rigorous. Nurse midwives and physicians alike might be supportive of water birth when they are supporting patients who want VBAC. Medical providers are on both sides of the fence for the water birth topic as well. If you are thinking about water birth, be sure to ask your medical provider for brochures and advice. You might be asked to attend a class to become more informed as well.
To pursue water birth, you must also be considered a low risk patient and if you are not, you can labor in the water and come out of the water for the birth.
The buoyancy is said to help ease the contractions when the patients are in the water and make them more able to endure the pain of labor.
Even if you choose not to have soaking in water play a role in your childbirth experience, you must be properly prepared by knowing your breathing exercises and relaxation exercises. Consider the importance of reading material and taking a class on the topic of childbirth. The Lamaze and Bradley childbirth techniques are two of the most popular to study.
Whatever way you choose to become a student of childbirth shall we say, be prepared!
Remember, no childbirth is predictable whether you are pursuing vaginal birth after 1 Cesarean section or after 2 or more Cesarean sections.
The labor process can last many more hours than expected or it can stall for many reasons.
If this occurs and causes your baby fetal distress for any reason, you may have to have another C section.
Whether your child is delivered by C section or vaginal delivery, what you will find is that the delivery of your child is AMAZING and exhilarating either way! When you hear the first cry and are given your baby to hold, you will be so grateful and joyful!