Quick Facts
If you have had a cesarean, your next baby can be born vaginally safely. This is called a VBAC or vaginal birth after cesarean.
The risk of uterine rupture (UR) after one “bikini cut” cesarean is 0.2% – 0.4% and the risk of infant death or injury is 0.05%. (Landon 2004, Gonen 2006, Cahill 2006)
Risk of miscarriage from an amniocentesis is 5 – 20 times greater than the risk of infant death or injury from a VBAC. (March of Dimes, Landon 2004)
A repeat cesarean section (RCS) lowers your risk of UR in your current pregnancy, but it does not eliminate it.
Additionally, the risk of complications increase with each RCS including your risk of UR in future pregnancies, whereas the risk of UR decreases by 50% after your first VBAC. (Mercer 2008)
In all 50 states, hospital and doctor attended VBACs are legal and in some states it is legal for a midwife to attend an OOH (out-of-hospital) VBAC, yet 90% of women have a RCS due to misinformation, hospital VBAC bans, and unsupportive medical professionals.
RCS risks to the mother: infection, prolonged pain, hysterectomy, hospital readmission, adhesions (internal scar tissue), infertility, hemorrhage, pulmonary embolism, heart attack, stroke, and death.
The CS rate in the US is 31%.
The World Health Organization says that 1/2 to 2/3 of these surgeries are unnecessary and contribute to our high infant and maternal mortality rates.
VBAC has risks.
Repeat cesarean has risks.
Be sure to understand the risks and benefits of VBAC versus the risk and benefits of repeat cesarean.
Read a letter written by two doctors supporting VBAC and opposing a VBAC ban.
Read a letter written by a certified nurse midwife supporting VBAC and opposing a VBAC ban.
Take the time to find a VBAC supportive provider.
Having a repeat cesarean does not guarantee a good outcome for you or your baby.
Read…
- Dr. Marsden Wagner’s Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First,
- Ina May Gaskin’s Ina May’s Guide to Childbirth,
- Henci Goer’s The Thinking Woman’s Guide to a Better Birth, and
- Dr. Sarah Buckley’s Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices
…as well as these articles from vbacfacts.com…
- I’m pregnant and want a VBAC, what do I do?,
- The Three Types of Care Providers Amongst OBs and Midwives,
- Homebirth vs hospital birth for the number cruncher,
- Hospital VBAC turned CS due to constant scare tactics,
- VBACing against the odds, and
- Comparing fetal death and injury: VBAC vs. amniocentesis/CVS.
Look for VBAC Classes presented by VBAC Facts in your area.
Find further information and support at www.childbirthconnection.com, www.ican-online.com, and www.midwiferytoday.com.
To purchase this information on a small business card for distribution, please see our Advocacy page.
I have had 3 prior c-sections:
#1:9/5/00=induction at 41 weeks. Fully dialated & pushed for 2 hours. Dr opted for c-section. Daughter born at 9lbs9oz.
#2:6/21/04=induction at 39 weeks. Dialated to 7cm. Dr noted compound presentation. Opted for c-section. Daughter born at 7lbs9oz.
#3:8/2/08=repeat c-section at 38 weeks. (water broke) Was told no other option but repeat c/s. Daughter born at 7lb4oz.
We are about to start trying for our 4th baby and I REALLY want a vaginal birth. I was SO close each time! I know that I can dialate. HELP!
[...] of the best references for VBAC information that I have found has been this site. Jennifer is AMAZING, a wealth of information, an advocate for all birthing women, a force in [...]
Christina, DO NOT consent to an induction. Your chances of UR increase with induction. Without knowing everything about you case I can say that your inductions most probably failed because your body was not ready to give birth yet.
Find a Midwife who can support you and give you more info.
[...] Quick Facts [...]
My first was a section and then I had 3 VBACs. Fantastic and no stress!
Dear Jen – Thank you for all the information on VBAC’s on your website.. It has been very enlightening for me. I was induced the first time at 41 weeks, was told my baby was large and was not advisable to wait any longer. Anyway after 24 hours, I ended up being a C-section. Me & my body did not do anything..everything was done by them….I was given cervix ripening agent..pitocin…epidural (I asked for it…twas very painful..I wish I had pain management techniques and someone to guide me thru those…I learned childbirth class is not enuff..maybe a doula would’ve helped in me having a vaginal birth)…they also broke my water..and finally I was told it would risk baby if we did not do C-section. This was 3 years ago, and I am pregnant again, and would hate to relive that experience. While reading about VBACs, I found I could have avoided my last C-section/induction, and I feel really sad and angry with myself for not keeping myself well-informed. I was in my own rosy world that it’ll be a natural birth and C-section is only the very last option. Me and hubby just went with what the nurses and doc told us at that time.
Anyway, this time I am determined for VBAC. I am 25 weeks pregnant, and my OB says she will give me a date by which if I do not labor on my own, she will do a C-section. But she cannot give me the date now, only later in last week of December (I’ll be 31 weeks then). I don’t know why we have to wait that long..maybe to find out if I have gestational diabetes or not, but again I am not sure. She is a very sweet & nice doctor..in fact both her kids were C-sections (I don’t think any woman would opt for C-section by choice). So, how can I tell if she is supportive of my VBAC or not? I go to her for 6 years now, and changing docs mid-pregnancy is an uncomfortable thought.
And on a more general note, since my first was induced which ended in C-section, what are my chances of going into labor on my own without induction. And is it possible to generally predict if will it be beyond 40 weeks or earlier or later ?
Please help…
Thanks,
Esha.
Esha,
I’m so sorry it took me so long to reply to your comment. Since it’s the last week in December now, I’m wondering what date your OB gave you. 40 weeks? 41 weeks? I suspect your OB wanted to wait until 31 weeks to give you the “labor or c-section” deadline because the later she waits in your pregnancy, the more likely it is you will stay with her, do what she says, and not switch care providers.
Here is what I would do: I would switch OBs. My personal opinion is a doctor who puts you on a timeline of give birth by X date or you are having a cesarean is not a VBAC supportive provider.
You might be surprised to know that many women opt for elective repeat cesareans because they are subtly, or not so subtly, encouraged to do so by their OBs. I would be interested in knowing if your OB scheduled her repeat cesarean without medical indication (suspecting a baby weighting less than 11 lbs or being overdue are not valid medical reasons) or if she truly wanted a VBAC and ended up with a cesarean after labor began.
Do you think that a woman who schedules an elective repeat cesarean for herself is a supporter of VBACs? Do you think she will truly support your desire to have a VBAC?
To answer your question, “since my first was induced which ended in C-section, what are my chances of going into labor on my own without induction?” With this provider, I would say your chances are slim to none. With another provider, who is supportive of VBAC and willing to wait for labor as long as you and baby are fine, your chances are much greater. Due dates vary greatly. Some women have longer menstrual cycles, some women just have longer pregnancies. You can learn more here: Figuring your due date.
You also asked, “And is it possible to generally predict if will it be beyond 40 weeks or earlier or later.” The fact that you were 41 weeks when she induced you means that it’s likely you will go to at least 41 weeks this pregnancy. The difference between your last pregnancy and this one is that you know this time around that she doesn’t support pregnancies going beyond 41 weeks. What do you think in your heart will happen if you stay with this OB?
I understand that you like your doctor and that she is sweet to you. But please know that liking your OB isn’t enough. You two should be on the same page in terms of your birthing philosophies.
You said, “I feel really sad and angry with myself for not keeping myself well-informed. I was in my own rosy world that it’ll be a natural birth and C-section is only the very last option. Me and hubby just went with what the nurses and doc told us at that time.” The question is, will you allow that to happen again?
If you want to look into finding a new provider, please read: Finding a VBAC supportive OB or midwife.
Please keep me posted!
Warmly,
Jen