The Rate of C-Section Deliveries has Increased
With the rate of cesarean section deliveries having increased over the last few years, having a VBAC, or vaginal birth after cesarean, has also increased in popularity. According to the CDC, close to 30% of births ended in a cesarean delivery (“Quickstats: percentage of,” 2009). Many women who have had prior C-sections are now electing to try for a vaginal delivery the second time around, and the good news is that a majority of them are candidates.
Risks of Having a VBAC
After having a C-section, the uterus becomes weakened at the incision line. This can put the uterus at risk for rupture as a result of the contractions during labor. In a woman who has had a single, low-lying and transverse (meaning side to side) incision, the risk of rupture is only about 1 in 500 births (ACOG, 1999). However, some studies have shown that the risk increases slightly when labor is induced or augmented using drugs like Pitocin.
What is Uterine Rupture?
A uterine rupture is when the uterus actually rips open during labor. This is a life-threatening emergency for both mom and baby.
Am I a Candidate for VBAC?
First and foremost, you should speak with your doctor about your risk for uterine rupture or other complications if you decide to attempt a VBAC. Each doctor (and birthing center) will have their own criteria for when a VBAC is appropriate. Generally speaking, if you’ve had an uncomplicated pregnancy, are in good health, the baby is of normal size and head down, and the original problem that caused the need for the C-section isn’t present with this pregnancy, you are a good candidate.
Most physicians will not allow you to attempt a VBAC if you are having multiples, if you’ve had multiple C-sections, or if you’ve had medical issues during your pregnancy. In addition, if there was a medical reason for your last C-section, such as an issue with the baby or your own health, your doctor may not want to put either of your lives at stake by trying a VBAC.
How is Labor for a VBAC Different?
It’s not too different than a standard vaginal delivery. You are still able to get pain medication, like an epidural or spinal anesthesia. The biggest difference is that you will be monitored much more frequently and carefully during your labor to watch for potential complications.