Over the course of the past 15 years, I have come across a lot of misinformation about VBAC. All of the myths below have come straight from readers who have asked me, “Is this true?” And every single time, the answer as been, “No.” I thought it was time to pluck out the most pervasive VBAC myths and assemble them into one article… and downloadable handout. These myths cover basic things like uterine rupture rates to difficult topics like death and logistical things like hospital policy. In the end, all of these myths confuse birthing women and people about their options making it impossible for them to make a truly informed decision between vaginal birth after cesarean (VBAC) and elective repeat cesarean section.
An advocate claims that the American College of Obstetricians & Gynecologists (ACOG) said VBAC after more than one prior cesarean (VBAMC) doesn’t pose an increased risk. A reader contacted me asking if this was correct. It is not. ACOG does not say that because it’s not true.
It’s important to use clear, specific language when we talk about birth because there is a lot of confusion among moms, advocates, doulas, and health care providers about VBAC and induction. When I point out the lack of clarity many people have on the topic to “anti-induction advocates” (for the lack of a better term), they respond with the fact that their focus is warning moms about elective inductions, which is absolutely needed. And they genuinely believe that people are aware of the distinction between elective and medically-indicated inductions. However, that has not been my experience, in fact it’s been quite the opposite. There are many people who don’t understand the why, when, and how of inducing VBACs and that is impacting the abilities of women to make informed decisions and exercise their right of patient autonomy.
Many moms and midwives use evening primrose oil (EPO) for cervical ripening. So I was absolutely shocked at the complete lack of evidence on the effectiveness and safety of EPO use among pregnant women. There are only two studies that examine the oral use EPO and its ability to ripen the cervix during pregnancy. There are no studies on the vaginal use of EPO. In short, there is insufficient clinical evidence documenting the risks and benefits of EPO and without that information, the question is, should pregnant women take it?
Becky recently ask this question on the VBAC Facts Community:”I read somewhere that the risk of uterine rupture is actually higher during pregnancy than during birth. Does anyone have a source for this?”
While these statements are very comforting, as birth myths tend to be, they are false comparisons. We can accurately and fairly compare the risks of a planned VBAC to the risks of a repeat cesarean or the risks of a first time parent. However, it is a misleading to compare the risks of birth to non-birth events.