Almost one woman in three in the United States will have her baby surgically, by c-section. Many women would prefer to avoid surgery, but what if you’ve already had one cesarean? Is it really safe to have a VBAC (Vaginal Birth After Cesarean)? The science says yes! The main risk involved with VBAC is that of having a uterine rupture, but the risk of that happening is extremely low, occurring in fewer than 1% of women. When deciding whether to have a VBAC or a repeat cesarean, be sure to also consider the risks of a c-section. Take into account that the risk of some things increases with each addition c-section.
A new study found women having a vaginal birth after three cesareans have the same odds of a successful VBAC and the same level of risk as women planning a vaginal birth after just one cesarean. Even if you’ve had more than one cesarean, you aren’t forced to continue to have c-sections. http://www3.interscience. wiley.com/ journal/12326660 8/abstract? CRETRY=1&SRETRY=0
If you think you’d like to have a VBAC, here are some tips:
- Find a supportive caregiver. This is often the most challenging part of planning a VBAC! But truly supportive midwives and obstetricians do exist.
- A great source of information regarding cesarean sections and VBAC is the International Cesarean Awareness Network. The national group is here, and our local Atlanta chapter is here. The Atlanta group includes a message board where you can find reviews of care providers.
- Take a good childbirth class. Even if you plan to get an epidural, a natural birth class tends to be much more thorough than a prepared birth class. You want to get as much consumer information as possible when planning your birth. Baby Steps offers classes, and there are many other organizations that have good classes as well.
- Hire a doula. Having a doula reduces the c-section rate by half, in addition to making your labor more comfortable.
My second c-section was 31 years 3 months ago, and my ob-gyn and I discussed the possibility of trying a vaginal delivery. At that time, you couldn’t have any pain meds for the simple reason that if there were a rupture, the mother would know it before anyone else – as long as she could feel. Meds would block that, and it could lead to major problems. The other stipulation was that the entire labor would have to be under supervision, so that should surgery be necessary, it could be done quickly.
I don’t know if the protocol has changed by now, over 31 years later. I opted for a second section, and have never regretted it. Well….for a few days after, I did my share of moaning and groaning…but no real regret.
My first section, 7 years before the second (oddly, it’s usually 7 years between sections), was scary and memorable. It was due to a placenta previa, before sonograms, so there was no clue until it broke loose, on a Saturday, naturally, when there was no O.R. staff. No discussion with the gas-passer, either, so everyone was unprepared for the discovery that the drug used in the epidural was one I’m immune to, and once it was administered, they couldn’t give me anything else until they got my son out. Fortunately, I had taken a LaMaze course, and used the breathing to help get through this. Unfortunately, they had given me a tranquilizer shot, which hurt my focus. BUT, both my son and I survived, and are still going strong. I wouldn’t volunteer to repeat the experience, but it didn’t kill me, either.
Comment by Joanne — February 12, 2010 @ 8:36 pm
Previa is definitely a medical reason to have a c-section. 31 years ago, the c-section rate wasn’t anywhere near what it is now. Most women aren’t killed by their c-sections of course, but for 1/3 of women to be having babies surgically is not the safest or easiest way for babies to be born.
Comment by laurafields — February 13, 2010 @ 7:37 am