(International) Cesarean Awareness Month on April, 2023: Has anyone had a successful Vbac?
April, 2023 is (International) Cesarean Awareness Month 2023. Cesarean Awareness Month Cesarean Awareness Month,
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VBAC (vaginal birth after Cesarean) can be difficult to come by - far more difficult than it should be. The risks associated with VBAC (namely, uterine rupture) have been highly overblown by some in the medical community, mostly for liability reasons.
The rate of rupture does vary depending on certain factors relating to your birth and your Cesarean. If your Cesarean was preformed with a low transverse (bikini) incision, your rupture rate would likely be very low. Women who have a classical (horizontal) or T-shaped incision have a much higher rupture rate. The rate of rupture also increases with the number of Cesareans you have. VBACs are still definitely possible after multiple Cesareans. They would just require a little more observation and planning.
The rate of rupture also increases if certain interventions are used during a trial of labor with a second pregnancy. Certain labor inducing drugs, like Cytotec, Cervadil, and even Pitocin have been associated with higher risks of uterine rupture.
The reason for your Cesareans can also make a slight difference in whether or not you'll find a practitioner that will attend a VBAC. What was the reason?
Overall, for most women, VBAC after one Cesarean with a low transverse incision is a very safe option, and many argue that it's even safer than a repeat Cesarean. There's also more and more researching emerging about the safety of VBACs after multiple Cesareans as well. Here's a few resources for you, specifically on VBAMC (vaginal birth after multiple Cesareans):
Here's some studies citing the safety of VBAMC:
A friend of mine had a VBA2C not too long ago, and it was a great experience for her.
Please see these links for more information on the safety of VBACs in general:
International Cesarean Awareness Network: (look to the left for more informative links)
"Neonatal outcomes better with VBAC":
Avoiding an Unnecesarean:
I had a completely drug free, unmedicated VBAC at a freestanding birth center about 21 months ago. I'll give you some of my advice, based on my experience and research.
First of all, I would read every pro-VBAC book you can get your hands on. I liked The VBAC Companion by Diana Korte. It's a little old, but a lot of the information still applies. I found it very helpful.
Being educated is VERY important. The more information and knowledge I had, the more confident I was. I can't stress that enough. Knowledge is power.
Secondly, I also hired a doula to be with me and DH during my labor. She was a very pro-VBAC doula who'd attended several VBACs before. I took a childbirth class through her as well. Studies show that women who have doulas present during their L&D have fewer interventions, including Cesareans.
If you'd prefer not to have a doula, you could consider having a good friend or family member - one that is very supportive and informed about your birth wishes - attend your birth with you. Studies show that a supportive environment is a very integral part of a healthy, safe, and satisfying birth experience.
Third, I would also try to avoid an epidural, if you can. Epidurals increase your need for all sorts of interventions, including Pitocin, vacuum, forceps, episiotomy, and Cesarean. They also increase the rate of breastfeeding difficulty, lengthen labor, and make the pushing stage longer and more difficult. Here's a lengthy overview of the risks:
I would avoid an induction as well. Inductions should only be done if the health of the mother or the baby is in danger. Here's some good articles on the risks of inducing labor. It discusses several different induction methods:
Fourth, if you can find a midwife and/or a freestanding birth center (or even look into the possibility of a homebirth), your chances of having a VBAC would likely be much greater. Hospitals tend to have a lot of outdated policies that end up resulting in more interventions and greater chances for Cesareans, not to mention other complications, like fetal distress and higher maternal and neonatal mortality rates. Giving birth outside a hospital with a licensed midwife has been shown to be as safe or safer than hospital birth:
Some hospitals have policies against VBAC, too, and not all OBs will attend them. Midwives, in my opinion, are the best option for VBACs. Many of them practice under the supervision of a doctor (by law, in some states).
I chose a freestanding birth center because I didn't want to be subjected to so many unnecessary and even dangerous interventions that happen at hospitals. The birth center was right next to the hospital, so in the event of an emergency (which is very rare), we could get there in no time.
If you have any more questions about VBAC, please do send me a message. I've had a VBAC, and I've done a lot of research on them. I'd be happy to help you any way I can. Most likely, you won't have to have a Cesarean for all of your future births.
I also highly recommend reading "Pushed" by Jennifer Block. You can also check out VBAC.com, ICANonline.org, VBACfacts.com, the Unnecesarean.com, and Pushed.com for more info. Good luck!
Ladies~have you attempted a VBA2C or know someone that has? If so, how did it go?
I had a VBA2C 16 months ago. Its possible with an educated and supportive provider (whether midwife or OB; whether at home or in the hospital.) I went completely unmedicated. To get a good feel for it and to find a doctor that will be supportive find your local ICAN (International Cesarean Awareness Network Chapter.) Through them I found actual statistics, women who were successful, some who weren't, and a midwife who supported me through my labor. Now I am pregnant again and having a home birth!
VBAC after twins?
Talk to ICAN (International Cesarean Awareness Network) if anyone has that information it would be them.
However your best option may be a homebirth however for a VBAC that probably means going it alone. Please know that in general in major urban centres the time for "decision to incision" is less for those dialing 911 then those already in the hospital. If you are interested check out: