Consider All Your Options

Having a vaginal birth after cesarean, or VBAC, is a huge topic and a sensitive one. Nonetheless, if you have given birth by cesarean section, you may be considering a VBAC for your next birth; Or you may feel that there are no options for anything other than a repeat cesarean birth! As birth doulas we serve all kinds of families: First time parents to be, second time parents who want a different experience, single women, same sex couples, and of course inquiries from women who have had a cesarean and do not want a repeat of the same. They may question the reasons why their first birth resulted in a surgical procedure. Some women feel completely at ease with a healthy baby, trusting that a cesarean birth was the best and safest way for their child to arrive into this world, while other women may feel traumatized and scarred by the experience with no real way to express this particular and unique loss of their ideal birth experience.  Many women simply exist in the gray area between these two realities, but very much want to deliver vaginally with their next birth.
With doula support, the likelihood of having a cesarean decreases and the likelihood of having a successful VBAC can increase, as stated so well by a previous client, “Agreeing to a cesarean did not feel like much of a choice the first time around. I felt pressure and fear and agreed to what I felt was best in that moment. I knew I did not want the same feeling of helplessness at my next birth. With (my doula) by my side, I had the confidence and knowledge to find a local doctor who would support my decision, and ultimately had the birth I missed out on the first time around.” Not everyone does, or should feel this way, but if you or someone you know does, know that you have options and that there are supportive doctors in our area.
There are, of course, risks associated with trying for a VBAC.  The biggest risk associated with a VBAC is uterine rupture; yet according to the American College of Obstetrics and Gynecologists (ACOG), the risk of uterine rupture is between 0.5% and 0.9% for all births. We would also like to note, uterine rupture is also a risk during any labor/birth with no previous cesarean history, particularly when being induced.  ACOG also states that a VBAC is a “safe and appropriate choice for most women” with one prior cesarean birth, as well as for “most women” who have had two prior cesarean births. They also state that being pregnant with twins, going over 40 weeks gestation, suspecting a big baby, or having an unknown or low vertical scar should not be reasons that keep a woman from planning a VBAC. While there are most definitely risks to attempting a VBAC, there are also many resources that show that a normal, healthy pregnancy can most surely result in a vaginal delivery.
How does our area look in terms of VBAC’s?  Here are some numbers for some of our local hospitals. Here are the cesarean and VBAC rates from 2011 from three of our local hospitals, from the Office of Statewide Health.  This information is current as of 2011.
The reason this is important is because there are actually statistics for VBAC’s in our area, which means they are a possibility and are happening.  While we can’t endorse any one Obstetrician over another (in our area) who would 100% agree to a VBAC, we know they are out there. This is important. Other options for the opportunity of trying for a VBAC are to use a local homebirth midwife, and while homebirth may not have felt like an option before, it is certainly a wonderful way to try for a VBAC.

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