Trying to predict who will have a VBAC is tricky. We know some individual factors, such as having a prior vaginal delivery, are associated with higher or lower VBAC rates. By combining various factors, VBAC calculators generate a percentage that represents the best guess for an individual’s odds of having a vaginal birth after cesarean.
So what matters more: Our personal experience? Or the conclusions of medical evidence? I suspect that most of my readers would say, the evidence. Hands down. And that is what most people believe… until they experience a bad outcome. That’s when things become more complicated. That single event can override all their knowledge. Everything they believed to be true. Suddenly all those statistics from the research come flying off the page. They are no longer just a number. They are now associated with a face… a baby… a parent.
A reader recently asked, “I wonder however if there are studies that compare the method of induction. My Doula said that the increase rates of uterine/ scar rupture was due to using high dosages of Pitocin, but now the induction uses lower dosages and administered at longer intervals. Do you know something about this?”
Some women find the TOLAC acronym offensive, because it implies “trying,” so practitioners sensitive to this may want to use the phrase “planning a VBAC.” Understanding that TOLAC isn’t a dig at moms, but just a straightforward, objective term that care providers use, can (hopefully) take the sting out of the word.
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 TOLAC to the risks of a repeat cesarean or the risks of a first time time. However, it is a misleading to compare the risks of birth to non-birth events.