Hi Mama! Today I’m going to be discussing preparing for VBAC birth! What Is a VBAC, you ask?
Vaginal Birth After Cesarean…ALSO known as TOLAC (Trial of Labor After Cesarean)…
Basically, you’ve had one (or more) C-Sections in the past, and you’re attempting to deliver your NEXT baby vaginally! We have a TON of VBAC’s at the hospital I work at, and I would describe us as VERY VBAC friendly. 😊
PREPARING FOR VBAC: WHY SHOULD I HAVE A VBAC?
A vaginal delivery outweighs ANOTHER cesarean delivery more times than not. No surgical interventions, a shorter hospital stay, and a speedy postpartum recovery…just to name a few!
It’s also important to think about the future…If you’re considering having more children, having a VBAC will help you avoid the risks of multiple cesarean deliveries such as problems with your placenta!
SOME VBAC FACTS
In 2016, the C-Section rate in the United States topped out at a whopping 31.9%
Some C-Sections are warranted (MANY of them are warranted), but there are still providers who do them for unnecessary reasons (convenience being the #1 reason).
That’s pretty darn high…
BUT, one way to decrease this statistic? Become informed about having a VBAC! I come into contact with many women who have NO IDEA that you can have a vaginal delivery after you have a C-section.
It boggles my mind, and that’s simply NOT TRUE! In fact, 90% of women who have had a previous C-Section are candidates for a VBAC delivery.
That’s right, you heard me, NINETY PERCENT.
Okay, but let’s go over that 90%…
First of all, just because you are a candidate for a VBAC, DOES NOT mean you need to (or should) have one!
Before we go into more of the goodness that VBAC’s can bring, let’s talk about RISKS real quick…(because just like ANYTHING, there are risks with VBACs too!)
UTERINE RUPTURE. That’s the biggie.
A uterine rupture is super scary, and can be life-threatening to mom and baby. During a uterine rupture, the uterus tears open, and you’ll need to have an emergency Cesarean Section.
Very rarely do they actually happen (less than 1 percent of women who choose to VBAC), but they do happen, and your provider will explain this to you when you come into the hospital to labor.
Very, very rarely your uterus may have to be removed (a hysterectomy) if you experience a uterine rupture. This typically happens if your bleeding is poorly controlled during surgical intervention, and it’s usually done pretty quickly, to save your life.
Obviously, if your uterus is removed, you will no longer be able to become pregnant.
I know that’s harsh to say, but those are the risks! Very, very small risks but they are still risks!
ARE YOU ELIGIBLE FOR A VBAC?
There’s a fancy VBAC calculator that your provider will use to determine your VBAC success rate!
Basically, you enter your demographics, previous info about your C-section(s), current cervical check, and medical history…and BLAM, the fancy VBAC calculator gives you an evidenced-based percentage of being able to successfully deliver your baby vaginally.
But see, even if you only have a 15% chance of delivering vaginally according to the VBAC calculator, you still fall within that 90% (that’s why it’s so high).
Who are the 10% of women who CANNOT VBAC? Good question.
If you’ve ever had a uterine rupture (remember we talked about this one?), or a classical incision for your previous C-Section…sorry, but you absolutely cannot deliver vaginally, and your provider will counsel you otherwise.
(a classical incision is an incision that is vertical on your uterus, instead of low & horizontal…it carries a MUCH higher risk of having a uterine rupture, which is why it’s contraindicated.)
There are a few other contraindications to delivering vaginally (such as having a previa, baby’s positioning, and/or baby’s tolerance to labor…), but these are all grouped together with NORMAL contraindications to a vaginal delivery (regardless of if you’ve had a C-Section before)
***If you’d like to read more about C-Sections….go here!!***
Alright, so once your provider has determined your success rate (with the fancy VBAC calculator), now it’s decision time.
It’s YOUR decision whether you want to take the percentage that your provider has given you, and attempt a VBAC…and it’s also your PROVIDER’s choice as to whether he/she will support you in your decision to VBAC.
There are MANY providers who are not so comfortable with VBAC’s, so RULE NUMBER ONE:
If you’re pregnant and interested in attempting a VBAC…find a willing and skilled provider!
This is soooo important to successfully delivering vaginally. Many providers (and hospitals) nowadays will deny a mom a VBAC, so it’s important to do some research around your area.
Interview your provider, ask him/her questions about the success rates, the guidelines of the hospital, and how a typical VBAC is run…
Will they allow you do to be induced? Or will they only support your VBAC if you’re already in labor yourself? (This is a big factor that changes the VBAC calculator)
A few other questions to ask your provider about VBAC’s:
- How long will I be given to successfully VBAC?
- What is your (and your hospital’s) success rate?
- How does your on-call schedule work? If YOU are unavailable during my delivery day…will your colleagues support my decision to VBAC? What are THEIR success rates?
As you can see…VBAC’s can become very complicated. And they totally shouldn’t be!
OKAY, LET’S GET TO THE REASON WHY YOU PROBABLY CLICKED ON THIS ARTICLE!
HOW DO I INCREASE MY VBAC SUCCESS RATE?
Yes, you heard me! There are many things you can do to INCREASE the likelihood that you’ll deliver vaginally! Woohoo!
- I’ve already highlighted one of them…become informed 😊 The more INFORMED you are about successfully VBAC-ing, the MORE likely you are to succeed in your goal!
- Go into labor spontaneously (on your own), and avoid being induced. This is a biggie. Successful VBAC’s do happen when they are induced, but it’s MUCH more likely to happen if your body is already taking the necessary steps!
- TRY YOUR BEST to either deliver without an epidural, or wait as long as you possibly can before receiving one. IDEALLY when you’ve hit the active labor stage (after 6-7 centimeters).
It’s hard, I know. I delivered my son without an epidural, and girl I feel you. Those labor contractions are NO JOKE.
The truth is, your provider may tell you that epidurals bear no weight on whether you’ll end up with a C-Section…
There are a TON of evidenced-based articles out there saying so….I GET IT!
I’m just trying to explain to you what I’ve seen in the delivery room, time and time again…
Patient gets epidural. Contractions slow down. Pitocin is started. Baby starts to NOT like Pitocin. Pitocin stopped/slowed. Contraction pattern gets weird. Patient stops dilating. Hours go by. Patient ruled “failure to progress”. C-Section.
Patient gets epidural. Baby gets in a funky position in pelvis. Mom is confined to bed because of epidural. Baby stuck in weird position, without Mom’s free movement during labor. Mom pushes for hours. Baby doesn’t descend because he’s in that weird position. Patient ruled “failure to descend”. C-Section.
***There are others***
There are also many outcomes where patients end up getting epidurals and they do totally fine! I’ve seen it both ways.
WHAT I DON’T SEE TOO OFTEN….A natural VBAC-er getting a C-Section! It’s a very personal choice, but I encourage you to try and labor as long as you can naturally!
***If you want to learn more about going natural, read this article! It’s one of my most popular ones on my whole site, and it might allow you to have the VBAC you want!***
Hire a Doula!
- This goes along with delivering naturally…(even though you can hire a doula if you plan on getting an epidural too!).
Research has proven that hiring a doula during your labor significantly reduces your likelihood of requiring a C-Section!
Learn more about Doulas and how to find one in your area here!
There you have it! Planning a VBAC? I’d love to hear from you!! Comment below so I know where all my lovely VBAC mommies are!
Have any more tips? Let me know! I’d be happy to add to this article!
Here’s a quick little video I found talking about VBAC’s if you’re interested!