More than a third of all babies born in Northern Virginia and Metro DC (35-40% depending on the hospital) are delivered surgically. Every C-section leaves parents with a decision to make if they become pregnant again: repeat Cesarean section or vaginal birth after Cesarean (commonly referred to as VBAC)?
Talk to your doctor or midwife about your options. Based on your medical history, they can make recommendations to help you achieve the birth experience you desire. Your choices may include:
- Scheduled Cesarean birth
- Gentle or family-centered Cesarean birth
- Laboring to achieve a vaginal birth
- Hospital or home birth (depending on your primary care provider)
If you feel that vaginal birth is suitable for you and your primary care provider disagrees, get a second opinion from another maternity care provider. Some doctors and midwives are more comfortable with VBAC than others. Your local ICAN is an excellent resource for discovering if your doctor is VBAC friendly.
Think a VBAC might be right for you? Let’s talk VBAC facts!
VBAC (Vaginal Birth After Cesarean) has real benefits for you and your baby.
Your desire to experience a vaginal birth is valid all on its own. Still, successful vaginal birth after a Cesarean section has significant benefits compared to a repeat Cesarean birth. According to the American College of Obstetricians and Gynecologists (ACOG), vaginal birth after Cesarean benefits include:
- Avoidance of abdominal surgery and risks associated with multiple C-sections, such as hysterectomy, bowel or bladder injury, and placenta problems
- Shorter postpartum recovery time
- Decreased risk of infection
- Reduced blood loss
There are risks associated with VBAC.
When you are laboring to achieve a VBAC, it is called TOLAC (Trial of Labor After Cesarean). A successful VBAC has similar risks to any other vaginal birth. Some people choose not to attempt a VBAC because there is an infrequent but serious risk of uterine rupture. This risk increases depending on the type of incision you received during your previous C-section. A uterine rupture can harm both you and your baby.
Uterine rupture may occur in up to 0.5% of all TOLACs. When it happens, the uterus tears, usually along the line of the previous C-section scar. Uterine rupture requires immediate surgery, and in up to 5% of uterine ruptures there are further complications, such as excess blood loss or infant death. Your risk factor is increased (but still very low) if your:
- most recent birth was less than 24 months ago
- labor is induced or augmented
The above risk factors do not mean that planning a VBAC is unsafe. Uterine rupture is rare. Your doctor or midwife and your doula can help you weigh the risks and benefits based on your goals for birth.
A VBAC Certified Doula can help you meet your goals for a vaginal birth.
Choosing a VBAC can feel overwhelming. A Certified VBAC Doula can help you navigate the uncertainty and increase confidence to have a vaginal birth after a prior Cesarean. Our VBAC Doula Package includes bonuses like:
- Birth Story Reflection session (in-person) to help you process your last birth.
- Comfort Measures and Labor Techniques session (in-person) to help you prepare.
- VBAC hypno-birthing MP3 file
- VBAC Essentials Guidebook
There is such thing as VBA2C and VBA3C!
You may still be able to plan for a vaginal birth if you have had more than one Cesarean section. In Northern Virginia and Metro DC, some medical care providers support vaginal birth after two and even three Cesarean deliveries.
Homebirth may be an option.
The American College of Obstetricians and Gynecologists recommends that TOLAC occur only in the hospital. However, no significant research shows that VBAC is less safe when attempted in a supported home or birth center environment. At least one analysis suggests that parents birthing at home experience less medical intervention and fewer Cesarean births. Some midwives support HBAC (Home Birth After Cesarean) and can help you decide if this option is right for you.
You have pain relief options when attempting a vaginal birth.
Attempting a vaginal birth doesn’t mean you have to birth without medication or pain relief.
The same pain relief options available to those who have not had a previous surgical birth are generally available to you when attempting a vaginal birth after a prior C-section. You may choose non-pharmacological pain relief such as:
- essential oils
Medical options available to you include:
- nitrous oxide
Discuss the many, many options you have for laboring comfortably with a VBAC certified doula.
No matter how you choose to give birth after having a previous Cesarean section, you have options. Talking to your doctor, midwife, childbirth educator, and your VBAC certified doula will help you prepare for the birth that is right for you and your family.