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.
When I found out that ACOG released their new guidelines yesterday, I couldn’t wait to devour them. This morning, I had an opportunity to cuddle up with the new recommendations and I’m quite pleased. As always, there are things to like and areas where I think ACOG missed the mark. But here are the eleven good things about ACOG’s 2017 VBAC guidelines.
I’m in an online group for labor & delivery nurses where the discussion of vaginal birth after cesarean (VBAC) at home came up. While some understood the massive VBAC barriers many women face, others simply said, “Find a hospital that supports VBAC.” I left a late-night comment stating that “finding another hospital that supports VBAC” is just not a reality in many areas of the country. It’s literally not possible. Not even in the highly populated state of California. I also suggested rather than calling women stupid or debating the validity of the decision to have a home VBAC , we should consider why women make this decision.
In 2010, I was sitting next to an OB/GYN during a lunch break at the National Institutes of Health VBAC Conference. She was telling me about how she had worked at a rural hospital, without 24/7 anesthesia, that offered vaginal birth after cesarean (VBAC). I asked her what they did in the event of an emergency. “I perform an emergency cesarean under local anesthetic,” she plainly stated.
“No one can force you to have a cesarean.” I see this all the time in message boards. That’s just not true. Let’s start with what is ethical and legal: Yes, no one can legally force you to have a cesarean. ACOG even says in their latest VBAC guidelines that “restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will.” So even if your facility has a VBAC ban, they still cannot force you to have surgery… legally or ethically. But then you have reality: It happens all the time, but it may look different than you expect.
My intention in attending this meeting was to amplify the voice of the consumer. I think sometimes it’s difficult for OBs who attend VBACs, or for those who live in communities where they have access to hospitals that allow VBAC, to understand that not everyone lives in that world.