VBAC's

[melimeli]

Delivering a baby vaginally after a C-section is a “safe and appropriate choice” for most women, the American College of Obstetricians and Gynecologists said Wednesday.

The practice has been discouraged by many doctors and insurers in recent years.

Under the new guidelines, women who have had two previous C-sections or are carrying twins are among those now considered appropriate candidates for a vaginal birth after Caesarean, or VBAC.   Between 60 and 80 percent of women who attempt VBAC will be sucessful, the doctors said.


The guidelines "emphasize the need for thorough counseling of benefits and risks, shared patient-doctor decision making, and the importance of patient autonomy," says Dr. Richard N. Waldman, ACOG's president, in a press release.  "The current C-section rate is undeniably high and absolutely concerns us ob-gyns."

The recommendations come after years of many American hospitals and doctors insisting women who have C-sections continue to do so with subsequent births.  The rate of Caesareans has increased from 5 percent in 1970 to over 31 percent in 2007.  Waldman blames the "onerous medical liability climate" for the dramatic increase in C-sesctions.   "Our primary goal is to promote the safest environment for labor and delivery, not to restrict women's access to VBAC."

Not every woman is a candidate for a VBAC.  Women who have to have an emergency C-section after attempting a VBAC may have a higher risk of injury. At the same time, a successful VBAC has fewer complications than a repeat Caesarean.  Click here for some of the pros and cons.  Experts say if you are thinking about having a VBAC, it is important to talk with your ob/gyn early in your pregnancy.

The conflict over the policy was captured on CNN in the story of Arizona resident Joy Szabo, who wanted to deliver her fourth child by VBAC. Because the hospital in her hometown, Page, Arizona, did not allow vaginal birth after Caesarean, Szabo had to  her family in the last weeks of her pregnancy and move to Phoenix to be near a facility that would allow her the childbirth she wanted.  (She delivered vaginally with no complications last December.)

[Juliaschill]

I wish my dr would have let me try, I have a c/s in 1990 and then a VBAC in 1992, only because the OR was full! I really wanted to try to have Stephen VBAC and they would not even talk about it, as it was he came early and it was best to have a c/s but I still wish they would have given us a choice instead of just saying I had to have a c/s, thanks for the post!!

[melimeli]

Yes you really have to be informed and stick to your guns, I researched and I personally said no induction with my vbac, and I would not do it if I went over my due date.  With my prior 2 babies I was induced so I felt there was no way I would go before my due date but I did by 8 days.  I already had my c planned on my due date.  At any tinge of problem I would go in for a C.  I did not have my heart set on vbac by all means necessary, But I wanted to try if possible.  I was given and immediate epidural (which is heaven) in case I had to have an emergency C and the baby was monitored constantly all my data was on a monitor at the nurses station so they could evaluate me at all times.  It worked for me but It doesn't for all, you do have to your homework and be prepared for a c if necessary

[alikat1205]

I wish anyone and everyone who wants one has access to good medical care and choice.  But to really know the risks and be ready.  I had a complete uterine rupture during VBAC attempt.  I had a horrible horrible horrible c/s and still no vaginal birth :( I am nearly 8 years out and my abdomen is still numb with no sensation and I had many other complications as well.  While c/s is a safe (relatively) procedure, I think the risks and complications are glossed over.  

During my first c/s, my baby was NOT in distress, I had only been in labor 8 hours.  My doctor just said baby is big, let's not wait.  With no discussion about what that meant to me.  My first c/s had a pretty easy recovery.  HOWEVER, c/s can set you up for secondary infertility, adenomyosis, future c/s, higher risk of uterine rupture (me), c/s can also result in hysterectomy, numbness that I experienced, etc.  These things are not fully discussed and/or disclosed.  My second c/s was horror movie material, and it was directly caused by that first c/s.  

[melimeli]

This was on the CNN web-site today...  I had a wonderful VBAC experience.  I was prepared to do another C if things got sketchy but everything was completely according to plan.  I went into labor around 7pm and has her with 3 pushes at 2am  perfect!

[rhondaspruce]

k, now all I have to do is convince my OB....