If you've delivered a baby by C-section and you're pregnant again, you might be able to choose between scheduling a repeat C-section or a vaginal birth after cesarean VBAC. For many women, VBAC is an option. In fact, research on women who attempt a trial of labor after cesarean TOLAC shows that about 60 to 80 percent have a successful vaginal delivery. VBAC isn't right for everyone, though.
Attempted vaginal birth after cesarean VBAC is associated with higher rates of adverse effects or death for mothers and infants, although absolute rates were low in mothers who attempted this type of birth, according to research in CMAJ Canadian Medical Association Journal. Carmen Young, University of Alberta. For women who have had a single previous cesarean section, the best mode of delivery in a later pregnancy is controversial, as there are risks and benefits to attempting a VBAC or having an elective repeat cesarean section. Attempted VBAC is associated with a higher risk of uterine rupture, hemorrhage and other maternal and infant complications. Repeat cesarean sections are associated with an increased risk of surgical complications and placental complications in subsequent pregnancies.
This decision will affect you, your baby and any future pregnancies. Unfortunately, quite a few hospitals and doctors do not support VBAC, even though the best research and professional guidelines support it in most cases. There are a number of reasons, including fear of lawsuits, insurance company restrictions and convenience of scheduled deliveries, among others. Ultimately though, the effect is the same: if you wish to use their services, you must accept surgical delivery. So what can you do?
Wonder if you're a good candidate for VBAC? If the benefits of VBAC outweigh the risks? The answer might be up to you. Here's help weighing the pros and cons.