Uterine rupture risk drops significantly after first VBAC
As we know, the risks of cesareans increase with each surgery which is why family size should be considered when evaluating your post-cesarean birth options. Couple that fact with the results of Mercer (2008) which found that successful VBAC also provides a level of protection to future deliveries.
Mercer found that not only do the risks of uterine rupture, uterine dehiscence and other peripartum complications decrease after the first VBAC, but “VBAC success increased with increasing number of prior VBACs” to rates over 90% for women with two or more prior VBACs. They also found that while two or more VBACs did not decrease the risk of rupture further (so a scarred mom’s risk of rupture never goes down to the risk of an unscarred mom), it’s important to note that the risk of rupture did not increase with subsequent VBACs as women are sometimes told in an effort to obtain their consent for a repeat cesarean.
Mercer, B. M., Gilbert, S., Landon, M. B., & Spong, C. Y. (2008). Labor Outcomes With Increasing Number of Prior Vaginal Births After Cesarean Delivery. Obstetrics & Gynecology , 11, 285-91. Retrieved from http://journals.lww.com/greenjournal/Fulltext/2008/02000/Labor_Outcomes_With_Increasing_Number_of_Prior.6.aspx
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Jen Kamel is the founder of VBAC Facts, an educational, training and consulting firm. As a nationally recognized VBAC strategist and consumer advocate, she has been invited to present Grand Rounds at a hospital, served as an expert witness in a legal proceeding, and has traveled the country educating hundreds of professionals and highly motivated parents. Even more have accessed her trainings online. She speaks at national conferences and has worked as a legislative consultant in various states focusing on midwifery legislation and regulations. She has testified multiple times in front of the California Medical Board and legislative committees on the importance of VBAC access and is the Secretary for the California Association of Midwives and the California Association of Licensed Midwives. Her favorite flavor of ice cream is peanut butter chocolate. And mint chip. And coffee.