VBAC, or a vaginal birth after cesarean, is a birth that is decreasing in numbers. In the past "Once a cesarean, always a cesarean"Â was commonplace. Most women who had experienced one cesarean would just simply have another if they become pregnant. In the early 1990s the push for mamas to try for VBAC births increased and the percentage of women having VBACs rose to just over 28% in the mid 90s.
Then in 1996 The New England Journal of Medicine published a study that showed some danger to women having a VBAC birth. However, their 'some danger' was a relatively low chance of uterine rupture (1.6 per thousand women). The media picked up on this andÂ people became nervous about VBACs again; dropping the rates of VBACs to new lows. As of 2004, the VBAC rate had dropped a whopping 67% since 1996. No surprise that in 2004 the cesarean rate rose to an all time high, accounting for 29.1% of all U.S. births.
The problem here, is that studies on VBAC danger, do not take into account that in actuality there is always a percentage of mamas who experience spontaneous uterine rupture or that uterine rupture is 3% more likely during a VBAC birth with pitocin -- which is used fairly liberally in most hospitals. Additionally a cesarean itself is major surgery and is not without complications.
From the American Academy of Family Physicians
"Based on the most recent evidence, the American Academy of Family Physicians (AAFP) revised its VBAC guidelines (March 2005) and now encourages women to consider labor after a prior cesarean and maternity care providers to support women's choice. The AAFP found no scientific evidence that having a surgical team and anesthesia "immediately available" when women labor for a VBAC significantly improved outcomes."
Today's rockin' mama Stacey has beat all the current statistics.
Stacey experienced a cesarean birth with her first daughter 12 years ago and then went on to have four VBACs... "My first daughter was breech so the subsequent VBACs were very different, lol.Â I've now given birth every way you could: c-section, breech, VBAC, drugs, no drugs and laying sideways.Â My doctors were all very supportive of having VBACs so it wasn't an issue.Â I was healthy, strong and could basically give birth standing on my head if needed."
Stacey was lucky to have doctors who supported her decisions. If you've had a past cesarean and want to try for a VBAC birth, don't let your care provider's doubt affect your decision. Get a second or third care providers opinion. If you need help finding information or a care provider who's on board with what you want, take a look some resources that can help you make informed decisions about maternity care and birth.
For more general VBAC information, check out the Best Evidence for VBAC Safety.