Planning Your VBAC (Part 1 of 2)

If you are considering a Vaginal Birth After Cesarean (VBAC), it is helpful to understand the benefits/risks, your options and how to find support for your VBAC. Our two part article explores all of the important information you should know when planning a VBAC.

Step 1: Know the Facts

What is a VBAC?

VBAC stands for Vaginal Birth After Cesarean. Mothers with one low transverse uterine scar have, on average, a 60-80% success rate with a trial of labor after cesarean (TOLAC) and VBAC birth. This means that the vast majority of mothers who want to have a vaginal birth after having had a c-section will be able to do so.

Why VBAC instead of a repeat cesarean?

There are many significant potential benefits to a vaginal birth rather than a repeat cesarean birth. VBAC, when compared to cesarean birth, results in shorter maternal hospitalizations, less blood loss and fewer blood transfusions, fewer infections, and fewer blood clots than a cesarean. VBAC also often results in a shorter recovery time and reduces a mother’s risk for complications in a future pregnancy due to repeated C-sections. Since 2010, the American College of Obstetrics and Gynecology has “supported VBAC as a safe and suitable choice" for women who have had a prior cesarean delivery and are appropriate candidates, including for some who have had two previous cesareans.” It’s also important that the mother’s experience during labor and birth be considered as a factor when planning a birth.

Are there risks to a VBAC?

Birth, as with any life event, carries a certain element of risk but for most mothers this risk is very small. The same is true statistically of VBAC. If a mother wishes to have a VBAC birth, she should talk with a trusted care provider about her individual risk factors because no two bodies or situations are the same. In general, the risk of a uterine rupture is higher than with a planned repeat cesarean, but still only occurs in less than 1% of cases wherein the mother has had one previous c-section.

Where can VBAC birth take place?

The decision about where to labor and give birth is best made between a mother, her partner and her care provider based on her individual situation and potential risk factors. Though rare, even low-risk labors and births -- VBAC or not -- can result in emergency situations at any time so it’s important to keep discussion of risk and emergency situations in context of the bigger picture, as well. A informed, supportive and trusted care provider is a key component to a successful VBAC regardless of where it happens. Some mothers may be most comfortable in a hospital settings, while others may prefer a birth center environment or home birth. Our article “Is your care provider VBAC-friendly?” can help you determine if your care provider is a good match for you when deciding on a VBAC.

Looking for more information when planning a VBAC?

International Cesarean Awareness Network website can provide additional information and resources, such as links to local chapters and support groups. VBAC.com and VBAC Facts are also helpful resources to consider.

Childbirth is an intensely personal and individual experience. No two mothers are the same and neither are their births. In the end, a mother should be treated with respect, given accurate and complete information, and supported in her decision.

Read on at Planning Your VBAC: Part 2, which provides practical, concrete steps to support a healthy and happy birth experience.

Jennifer Stutzman, Freelance Writer

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