VBAC

This topic is one I am a VERY strong supporter of. I plan to have one of these with all of my children from now on.

1 in 3 women have a Cesarean Section every year. This is just for a first Cesarean. Not subsequent ones. 90% of women choose to have an elective Cesarean with all of their children after they have their first surgery. Most of these women can have safe and successful vaginal births. The VBAC percentage fell 67% in the last ten years.

In a normal, low risk pregnancy, birth by Cesarean puts healthy pregnant women at risk for medical complications. What women don’t seem to understand is the a Cesarean is a major surgical proceedure. You are being cut open like any other surgery. It is the #1 surgery for women in our entire country. How is this safe?

Cesarean is a risk factor for the initation of breastfeeding. Medications and procedures administered during labor affect the infant’s behavior at the time of birth, which in turn affects the infant’s ability to suckle. And it doesn’t help that they are not allowed to nurse for at least 6 to 24 hours after their birth if they are healthy and there are no complications.

And then women get pregnant again, and doctors refuse to do VBACs since the lawsuits are higher, even though that’s mainly from stupid women that just want money…

The truly sad thing about VBAC is that the morbidity rate is 1/5 less than that of elective cesarean, but doctors only tell you about “uterine rupture”. The chance of uterine rupture in a VBAC is about 2%. It increases when the women is induced with pitocin, since it causes stronger contractions and increases the need for pain medication which can hide the pain from a rupture.

Uterine Rupture is less than 1% in low transverse incisions. And ruptures have been to known to occur in someone who has never had a cesarean. T or J shaped incisions is closer to 4-9%, verticle incision is 1-7%, a verticle incision in body of uterus is 4-9%. The symptoms of a rupture are bleeding, sharp pain between contractions, contractions that slow or become less intense, abdominal pain or tenderness, recession of baby’s head, bulging under pubic bone from the baby’s head leaving the uterus before the birth canal, and sharp onset of pain at site.

These are all terrifying. It does happen. But the risks of a repeat cesarean are far worse. Babies are more premature and need more oxygen at birth, you will have pain at the incision site for weeks or years, your postpartum is harder, less chance of successful breastfeeding, neonatal death, and maternal death.

The real reasoning most women have about trying a VBAC is a failed trial of labor, concerned about the ‘dangers’ of vaginal birth, fear of pain, and the convenience of scheduling their delivery. I don’t understand how these can be real reasons not to trust your body, but in our culture I can see why women would choose to schedule.

I truly blame this on celebrities. All of them have scheduled c-sections, followed by a tummy tuck since the doctor is already in there. If these women were having home water births, the cesarean rate in our country would plummet. It’s depressing how much control they have over what women want in their lives.

VBACs should be recommended for women who have a lower segment transverse incision. This is an incision that is horizontal in the lower part of the uterus. Even some women who have verticle lower incisions can have a VBAC without any trouble.

IS THIS NORMAL? If it isn’t normal for an animal, why is it normal for us?
So, if you have had a previous cesarean, please don’t give in to an elective repeat cesarean. The risks far outweigh the benefits.
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One Response

  1. My first was a horrible c-section too, and i hope with all my heart to have a vbac next time. and i would really like to have it at a birth center or at home, since i think the reason i had the c-section was mainly because i was in a hospital! but i didn’t know about how the incision was done effecting my outcome next time. i really don’t know how they did it! i guess i will have to find all this out next time i get pregnant…and just keep praying!thanks for a great post!

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