It’S A Common Belief That If A Woman Has Had One Cesarean Delivery, Subsequent Deliveries Must Also Happen By C-Section. New Research Is Attempting To Prove Otherwise, Giving Moms Hope For A Future Vaginal Birth. Find Out What Ob/Gyns And Mothers A

It’s a common belief that if a woman has had one cesarean delivery, subsequent deliveries must also happen by cesarean or c-section. New research is attempting to prove otherwise, giving moms hope for a future vaginal birth. Here what experts and real moms have to say about the risks and benefits of a vaginal birth after cesarean or VBAC.
Elizabeth Weiss McGolerick

Lynnsey Urbaitel is grateful for her vaginal birth after Cesarean (VBAC). “It was one of the most rewarding experiences of my life. It healed a lot of hurt that came with an emergency C-section. It allowed me to be more in tune with my body through labor and with my child when he was born,” she says. “I believe all mothers should have the choice to consider this option, because it is very possible under proper conditions.”

While studies are saying that moms who have undergone C-sections are in the clear for a vaginal delivery, there are still risks involved. The pros and cons of a VBAC vary widely.

Risks and benefits of a VBAC
A recent study, led by Dr. Alison G. Cahill of the Washington University School of Medicine, reports that women who attempt a vaginal birth after multiple C-sections may not have a greater risk of complications than women who attempt a vaginal birth after having had only one prior C-section.

However, Randy Fink, M.D., FACOG, medical director of the Miami Center of Excellence for Obstetrics and Gynecology, lists the numerous risks for a woman attempting a vaginal birth after one or more C-sections: blood clot, transfusion, emergency hysterectomy, uterine infection, maternal death, brain-damaged baby, fetal death and stillbirth.

“The greatest risk is uterine rupture,” Dr. Fink says. “The uterus is a muscle, just like one’s bicep,” and if you injure your bicep, you’re not going to be able to lift as much after the injury. “The uterus works similarly. A C-section forms a scar on the uterine muscle. That muscle is built for one purpose: to contract and ‘squeeze a baby out.’ During labor with a scarred uterus from a previous C-section, there is risk that the scar, a weaker area of muscle, may break open. This can be catastrophic for both mom and baby.”
Fink goes on to explain that, “When the trial of labor fails and she requires a repeat C-section, her risk of adverse outcomes is higher. Babies are worse off, as are the moms. And the problem is that one never knows who will be successful and who won’t.”

Harry M. McFarling, III, M.D., an ob/gyn affiliated with Atlanta’s Piedmont Hospital, adds, “The consensus is that women with a previous C-section that required a vertical incision in the uterus are not candidates for trial of labor because of the significant increase of uterine incision rupture during labor.”

Making the right choice
Even knowing these risks, many women strongly desire to have a VBAC. Vanessa van der Have is a mother of three who has had two successful VBACs. “It was emotionally difficult for me, being 24 and healthy, to have gone nine months and done the childbirth classes only to have an emergency C-section. I felt robbed of the birth experience. It was actually the main source of my postpartum blues. I wanted to avoid that the second and third time around.”

In Vanessa’s case, her doctor watched the progression of her pregnancy to see how Vanessa’s body responded in the last few weeks. For her, the outcome was wonderful.

Fink says, “There is one very important fact to understand about trial of labor after C-section. When it is successful, it is great. A vaginal delivery results in less pain, a faster recover and the potential for easier bonding between mother and baby,” says Fink. “There is usually less hospital time, a lower rate of abdominal wound complications and lower costs.” 
McFarling adds, “The decisions made concerning C-sections are practical and based on the many factors to be considered during a woman’s pregnancy and course of labor. A mother with another child at home, for instance, may choose the predictability of a scheduled C-section.”

In his practice, McFarling says, “I don’t encourage or discourage trials of labor after C-sections. I walk patients through the process and explain all the risks, benefits and options available. But ultimately, the mother accepts the risk associated with the method of delivery she chooses,” says McFarling.

Unfortunately, Fink notes that even if a patient accepts the possibility of a negative outcome, it is often the doctor who faces blame should a complication arise. For that reason, many mothers may encounter difficulty finding an ob/gyn willing to agree with VBAC. Often, in order to avoid liability, a practice as a whole does not offer VBACs, which is the case with Fink. “We seem to be doomed either way; we are seen as anti-natural medical beasts for wanting to perform a C-section, and are thrown to the wolves as incompetent for not performing a C-section [in the case of an adverse outcome]. So, many doctors choose to try to decrease their risk exposure by avoiding this area of high potential liability and blame.”

Though McFarling does work with mothers who are interested in VBAC, it comes down to a case-by-case basis. “We need to know why she had the first C-section. If it was due to failure to progress, if baby was too large or pelvis too small her risk would be greater than, say, a woman who had a C-section for another obstetrical problem that didn’t involve failure to progress in a previous labor.”

What the statistics say
The American College of Obstetrics and Gynecology (ACOG) doesn’t recommend vaginal delivery for any woman who has had three or more C-sections. Their risk of uterine rupture is thought to be higher. But the recent Cahill study found that of the 89 women who opted for a VBAC, none of them experienced this complication. This study’s findings suggest that it would be “reasonable to reconsider” the ACOG recommendation, at least according to Cahill.

But both Fink and McFarling attest that a woman’s risks of complications during delivery increase if she has had more than one C-section. “It is common to perform a repeat C-section and find the previous uterine scar to be paper thin – in fact, a window into the uterus,” says Fink. “For such a patient to labor, one would imagine the outcome would be bad. With only a single thin sheet of cells holding the uterus closed, a uterine rupture would be imminent.”

McFarling explains that placental implantation problems (placenta covering the cervix or growing into or through the uterine muscle) increase with each C-section as well as typical surgical procedure risks such as infection, bleeding and development of scar tissue. “In the case of repeated C-sections, the rate of rupture of the uterine incision during a trial of labor after one C-section is 560 in 100,000. That rate increases to 1,590 in 100,000 after a second C-section,” McFarling says.

Now, all of this being said, both doctors do agree that if a mother has had a vaginal birth before having a C-section with the next child, their chances of a successful VBAC are much higher because the woman has shown that she can deliver vaginally. “Situations like this are often a result of an obstetrical condition during the second pregnancy and birth that required the C-section and this condition may not be present during her third pregnancy allowing her to undergo trial of labor again,” McFarling says.

This should encourage some mothers who are strongly in favor of a VBAC. “The reason for the previous C-section is a very important factor to consider when a woman is weighing her options with her physician,” says McFarling. “If the mother had a long and difficult labor requiring C-section, I would not be as encouraging for a trial of labor. However, if her first C-section was necessary because the first baby was in a difficult position such as breech or because of a herpes flare-up during labor, then her ability to deliver vaginally is unknown. In subsequent pregnancies, if there were no complications such as breech she would be a candidate for vaginal birth and trial of labor.”
Ultimately, McFarling says, a VBAC is something a mother needs to discuss with her doctor. “Together they can weigh the risks and options to help mom make the best decision for herself and her family.”

Wondering what it is like to have a VBAC? Check out our birth stories submitted by real moms describing their birth experience with a VBAC.

More on labor and delivery:

-VBAC: Choosing your caregiver

-Overcoming a traumatic or disappointing childbirth experience

-Do twins need to be delivered via cesarean

Tags: benefits caregiver risks vbac

recommended for you


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carpinteyrowxn November 03, 2014
unnatural skin cells has been operation. Radiofrequency ablation is really a far less intrusive option.

Within the research, investigators in comparison great and bad the particular radiofrequency ablation procedure to sneak abnormal cells within the esophagus vs .. a good sham cure throughout Over a hundred people who Barrett's wind pipe. The two <a href=>canada goose men's expedition parka </a> processes involved endoscopy, or even the penetration of any catheter through the mouth area on the esophagus.

In the radiofrequency ablation procedure, the device using a set of electro-magnetic coils is put once your there of your defective mobile growth in your esophagus.

"Energy might be passed through your electro-magnetic curls as well as, given that small children what lengths a part this circles are moving and just how considerably vitality is being the subject of these individuals, we have an incredibly reliable level for burn up, techniques you possibly can eliminate uncommon cellular material over the inner surface without damaging the whole organ," examiner Nicholas Shaheen, Doctor, relate mentor at the Institution involving Vermont at Religious Mountain Educational institutions of Medicine, suggests inside a announcement introduction.

Total, the final results demonstrate that 77.4% of the given radiofrequency ablation stood a whole eradication from the unusual cell progress balanc <a href=>canada goose jackets uk sale </a> ed with 2.3% during the embarrass team Yr just after procedure.

Also, considerably a lower number of of them by using Barrett's wind pipe addressed with radiofrequency ablation got esophageal malignancy inside the study's One year new addition interval, One particular.2% as opposed to. Being unfaithful.3%.

There initially were no massive in connection with the method.

Other sorts of ablation are already learnt for Barrett's wind pipe, however gurus declare most of these results, publicized in the New England Paper of Medicine, would be the most encouraging to this point.New Remedy for Dilated Veins

A different answer to any from time to time damaging problematic vein problem is it being supplied locally.Amarillo Cardiovascular Group Health practitioner Ernesto Rivera suggests, "It was obviously a medical operation. Lately, it is happen to be a tremendous bonus inside the treatment of venous deficiency."While accountant los angeles treatment plans utilizing laser device and also radio frequency having a number of what about anesthesia ?, Rivera says this treatment is definitely minim

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henryyoy November 01, 2014
m while they provide this kind of crucial provider, nonetheless own suffered a decline in funding with London State Local authority or council.

Their purpose should be to give actions and also day trips for that kids using this revolves like browsing movie theatre, theatre or even zoo park.

They may be praying extra moms with all over Sheppey will probably enroll in all of them with his or her fundraising events endeavors.

A good ask nighttime to further improve capital is going to take place on Friday, The spring of Several, with Seven.30pm in the people group lounge, Way Court, down Way Near, Rushenden.Shepway Region Authorities leader Steve Monk is adament 0

"This have been realized although continuing to produce an great company to your online community, and we arrange to create which will during the on its way season. Many of us mean to keep the council taxes as of this place regarding 2015 2016.

"I 'm content we is effective in reducing debts for your authority tax payer whilst still ensuring all of our centre seems to be it has the best.

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He or she added in there would often be a 10% decrease in any Distinctive Purchase for the Folkestone Areas as well as Enjoyment Grounds charity signifying decrease costs designed for citizens inside Folkestone and Sandgate.Sheri Lynch involving 'Bob Sheri' radio clearly show visits California Crosse

A pay a visit to belongs to Robert Sheri's RVcrazy Head to over the Country.

Sheri sent out dwell from the Secret 105 studio room in Onalaska Thursday morning hours. And then the girl and also her workforce went to Riverside Park your car to meet up with admirers in addition to continue on this La Crosse California king. the particular workforce discontinued with the Kmart upon Mormon Coulee Streets inside L . a . Crosse to be able to load this Recreational vehicle. Admirers may stop by for that short park and fly.

"It's really humbling for the reason that whenever you do stereo, you are in a facility, you are actually talking to the micro or one and you also don't ever have which chance to obtain that personally communication using the

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henrybnd November 01, 2014
debbie in managing the actual flooding problems as well as badger cull was obviously a favorite of your right, Microsoft Truss once detailed the more common wing on the party when "the turnip Taleban" whenever a few men and women her South West Norfolk party aimed to deselect her own in excess of accusations around her exclusive daily life.

Even with briefings the reshuffle results in inside a very much higher share of women, the only additional different gals around the meal table is going to be job reverend Esther McVey plus new Alpha dog of your Lords Baroness Tina Stowell, that will not have whole Pantry ranking.

Anna Soubry, who was tipped to the Showcase, was developed No 2 in the Secretary of state for Protection.

In readiness with regard to the attempts to renegotiate great britain's resolution while using Eu, Mister Cameron designed the actual eurosceptic Philip Hammond his or her brand new Overseas Receptionist, swapping her with safety with all the Scottish given birth to Eileen Fallon, largely recognized seeing that "a harmless couple of hands".

Inside other major adjustments the optimal Minister assigned his ex - Leader of your Lords, The almighty Mountain, because their innovative Western european Commissioner.

The almighty Hill was a sizeable determine John Major's Maastricht discussions in acquiring elect outs regarding getting started with the ruskies and the public chapter.

Mister Cameron at the same time sacked Dominic Grieve while his legal professional common plus exchanged your ex together with Jeremy Wright <a href=>canada goose jacket cost </a> within a move that is viewed as a transmission that the Conservatives is going to guarantee in order to chuck man's Rights Take action and also American Seminar connected with Western european Liberties following your future election.

Their heads with the city service, There William Kerslake, can also be to move and be replaced by a completely new us president in the city program.

The previous not one but two reshuffles were considered to be generally depending Chancellor George Osborne, nevertheless, Tory experts known thi <a href=>canada goose photo jacket </a> s 1 "has the goal from the Prime Minister" using shut down collaborators involving Mister Osborne for example Mister Gove losing.

Mister Gove instructed Skies News flash this individual was presented a choice of if you should remain on and also relocate to possibly be Major Mix.

However it is fully understood in which her experience seemed to be closed from modern spat in excess of migrants with Property Secretary Theresa May well, i

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