Let’s be real; there can be a lot of myths, misconceptions and out-right misinformation about the risks of Vaginal Birth After Ceasarean (VBAC). Educating yourself and finding a care provider who informs their practice with the latest research and references is key to planning the safest birth for you and your baby. Here are some things to keep in mind as you ponder and plan.
1. Your uterus is strong and it will heal well
Good research continues to show that the risk of uterine rupture for a VBAC is very low and is comparable to other risks faced by birthing mothers without a history of ceasarean. Avoiding induction or augmentation is an easy way to reduce your risk of having a uterine rupture.
2. VBACs are healthy for babies
Vaginal birth is the biologically appropriate way for babies to be born and as the norm for our species, carries with it many elements that are important for a lifetime of health. Exposure to mom’s natural bacteria gets baby’s immune system started the right way, and all that good squeezing during the birth means fewer trips to the NICU or worries about breathing issues both at birth and beyond.
3. VBACs are healthy for moms
There is no question that a vaginal birth is safer than major abdominal surgery. Some studies have shown that mothers face at least twice the risk of death if they have a ceasarean due to complications from the surgery like blood clots, infection and embolism. And forget those myths about ‘protecting’ your vagina with a ceasarean: a study of nuns showed incontinence and prolapse occuring similarly to their child-bearing counterparts of the same age.
4. A VBAC is a good choice even if you’ve had more than one ceasarean
Dr. Mark Landon et al found in a large and well-designed study that VBAmC (m = multiple) mothers were not substantially at higher risk than VBAC moms, and that vaginal birth should be a reasonable option presented to them should they desire a trial of labour. (http://www.scfmresidency.com/SCFM_Curriculum/Journal_Club/10-19-06_Journal_Club/Uterine_Rupture_Article.pdf)
5. VBAC labours come in all shapes and sizes
Patient care providers recognize that sometimes the real reason a mother had a ceasarean previously was because she wasn’t supported through a labour that might have been a bit different than average. Having patience, avoiding induction or augmentation, and having a birth team equipped with a variety of ways to keep mom focused and supported through her unique labour can make all the difference for a successful VBAC.
6. VBAC moms come in all shapes and sizes
Many moms have been told they are ‘too small’ to have a baby vaginally or that they are ‘too overweight’ to do the same. However, we know from experience (and supported by research) that if you have a supportive care provider, all sizes of women can be great candidates for a VBAC. For an inspiring video of women who were all told they were too small to give birth but then subsequently birthed a bigger baby via VBAC, go to www.ican-online.org/questioncpd
7. VBAC is your choice, not your doctor’s
You are the one that ultimately gets to decide what your birth will be. VBAC is not a special procedure nor should it be treated as such. A doctor may have concerns about a VBAC versus a ceasarean, but they are not the ones that will bear the risk of either choice for the rest of their lives. A good care provider will offer solid research and resources to a mother making a decision, and then remind her that in the end, it is her decision to make.
Krista Cornish Scott is the Education Director with the International Cesarean Awareness Network (ICAN).
