VBAC. Can you do that at home?
“VBAC” means Vaginal Birth After Cesarean. Many people are still under the impression that a woman who has had a Cesarean section must have all the rest of her children by Cesarean as well. You may have heard the long outdated cliché, “Once a Cesarean – Always a Cesarean”. But this misperception has been the norm ONLY in the United States. Throughout the other industrialized nations of the world, it’s simply understood that if a woman needs a Cesarean for one baby, she can go ahead and give birth to the rest of her children … vaginally.
If you are considering having a VBAC, the first step will be to put away your preconceived fears. The only way to do that is to ditch that old cliché and reprogram your thoughts with accurate information. You’ll need to dig a little deeper than your doctor’s opinions (or your midwife’s opinions) and gather data from as many reputable sources as you can. The World Health Organization, the March of Dimes, Mayo Clinic, etc. Please don’t believe everything you read online. Anecdotal stories are not proof of anything. Collect well documented and evidence-based studies.
Certainly the greatest concern when considering a VBAC is that of uterine rupture. The American College of Obstetricians and Gynecologists reports the incidence of uterine rupture in attempted VBACs as 0.5%. The National Institute of Health reports the same number. That’s one half of one percent.
It’s an impressive low percentage. But it’s not perfect. Parenthood often involves choosing the best of two (or more) imperfect options. In the case of VBAC versus Cesarean, you’ll need to weigh the risks of both routes of delivery. You see, a repeat Cesarean section presents a set of risks as well.
In fact, compared to a VBAC, a repeat Cesarean section poses a greater risk of:
- Infection inside the uterus (endometriosis) or infection of the incision
- Postpartum hemorrhage
- Negative reactions to anesthesia
- Blood clots inside a deep vein – which can be life threatening
- Surgical injury to the mother’s bladder or bowel
- Surgical injury to the baby
- Breathing problems in the baby
It’s important to investigate and compare the data for both choices, VBAC or repeat Cesarean. But what about the place of birth? What about the care providers? Obviously, if you’re choosing a Cesarean, you will give birth in the hospital, and you’ll seek out the finest obstetric surgeons in your community to deliver your baby. But if you choose VBAC, the option of a home birth, as well as hospital, is indeed available to you. In both Montana and Wyoming, the State Boards which regulate and license midwives allow VBACs in the client’s home, assuming the client meets specific criteria defined by the respective states. You can read about these specifics via the following links:
Mountain Midwives have attended many home VBACs, within the scope of practice presented by these laws. We have plenty of satisfied clients, who can talk to you about their VBAC experiences, if you’re interested. Just give us a call and ask for VBAC references.
Cesarean section is an important and necessary method of delivery when certain complications and conditions arise. We are thankful that our local community includes outstanding physicians and facilities to perform surgical deliveries when needed. Here in Billings, we greatly appreciate the progressive policies of both of our hospitals, as they offer the choice of VBAC.
HOME BIRTH IS ONLY FOR LOW RISK MOMS. We’ve said this a million times! The American College of Obstetricians and Gynecologists considers VBAC to be low risk. Our state boards of midwifery consider VBAC to be low risk. We at Mountain Midwives consider VBAC to be low risk.
It’s up to you to decide how, where and with whom you will give birth. Don’t limit your options to only one way. Compare the pros and cons of each choice. Get healthy. Get informed. Figure out what’s right for you.