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8 years ago
Wednesday, April 27, 2011
To VBAC or Not?
VBAC is the term used to refer to a women who successfully gives birth vaginally after a previous c-section. A TOLAC (trial of labor after cesarean) is the term used for women who are trying to have a vaginal birth after cesarean.
60-80% of women attempting a VBAC will be successful (ACOG, 2010).
Benefits:
Lower risk of hemorrhage and infection
Faster recovery
Decreases risks associated with multiple cesareans such as injury to bowel, bladder, hysterectomy, and abnormal placenta placement
Less breathing problems with baby
The most common risk associated with a TOLAC is a uterine rupture, where the pressure from contractions causes the c-section scar to break open. This can rapidly cause hemorrhage or loss of oxygen to the baby and could result in a hysterectomy or death to mother, infant, or both. It sounds scary doesn't it? The actual risk of something like this happening is very low and it does depend on certain factors like how many previous c-sections you have had, whether or not your doctor is using pitocin to stimulate your contractions, etc. With one prior c-section the risk of a uterine rupture is less than 1% which means that only 1-10 out of 1000 women who are attempting a VBAC will have a uterine rupture. With high tech hospital facilities other subsequent complications such as hysterectomy and death are even more rare occurances.
There are also risks with considering an elective repeat cesarean and this may seem like a safer option but consider the risks:
Increased risk of breathing problems with baby call respiratory distress syndrome
Hemorrhage
Injury to bowel or bladder
Infection
Readmission to the hospital with complications
Increased risk of hysterectomy in future pregnancies due to abnormal placental locations
Increased risk of death compared to a vaginal delivery.
Midwives are known for low cesarean section rates and are the perfect choice for women considering TOLAC.
Great Resources: International Cesarean Awareness Network http://www.ican-online.org/
60-80% of women attempting a VBAC will be successful (ACOG, 2010).
Benefits:
Lower risk of hemorrhage and infection
Faster recovery
Decreases risks associated with multiple cesareans such as injury to bowel, bladder, hysterectomy, and abnormal placenta placement
Less breathing problems with baby
The most common risk associated with a TOLAC is a uterine rupture, where the pressure from contractions causes the c-section scar to break open. This can rapidly cause hemorrhage or loss of oxygen to the baby and could result in a hysterectomy or death to mother, infant, or both. It sounds scary doesn't it? The actual risk of something like this happening is very low and it does depend on certain factors like how many previous c-sections you have had, whether or not your doctor is using pitocin to stimulate your contractions, etc. With one prior c-section the risk of a uterine rupture is less than 1% which means that only 1-10 out of 1000 women who are attempting a VBAC will have a uterine rupture. With high tech hospital facilities other subsequent complications such as hysterectomy and death are even more rare occurances.
There are also risks with considering an elective repeat cesarean and this may seem like a safer option but consider the risks:
Increased risk of breathing problems with baby call respiratory distress syndrome
Hemorrhage
Injury to bowel or bladder
Infection
Readmission to the hospital with complications
Increased risk of hysterectomy in future pregnancies due to abnormal placental locations
Increased risk of death compared to a vaginal delivery.
Midwives are known for low cesarean section rates and are the perfect choice for women considering TOLAC.
Great Resources: International Cesarean Awareness Network http://www.ican-online.org/
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