Today Jaelin talks about VBAC safety and answers questions from her followers.
Points from the video:
Learn a little about the history of cesarean sections and the rise in number being performed.
What Does the Research Show About VBAC?
The big worry is always rupture of the uterine scar. VBACs were more common up until 1996. What happened?—Cytotec, a drug for labor augmentation, was introduced in the early 1990s. There were more ruptures and postpartum hemorrhages which led physicians to stop offering VBAC.
What are the risks of VBAC?
- What is the risk for uterine rupture? Normal vaginal birth risk: .007% vs prior c-section birth .64%
- This risk decreases with spontaneous labor and no augmentation.
- Risk for Mother—No maternal deaths with VBACs vs 21 per 100,000 births with repeat cesarean section delivery. That risk increases per repeat c-section.
- Risks for Baby—This is a little trickier as the research is all over the place. Some research says more increase, some say less risks, some say its equal risks as compared with c-section.
- 6% of ruptures are fatal for the infant.
- 14-33% of ruptures require a hysterectomy.
- A number of factors are known to increase the risk of rupture such as induction of labor and the number of previous c-sections, however, with each additional c-section comes a greater increase of maternal/fetal mortality and complications.
- Prior vaginal birth decreases risks of rupture by 600%
- The NIH panel concluded that a trial of labor is a reasonable option for many pregnant women with one prior C-section with a low transverse uterine incision.
AHRQ-agency for healthcare research and quality states with physician care successful VBAC 74% vs 87% with out of hospital births. With rupture rates for out of hospital as low as 1% in some studies (Meaning out of all the ruptures that do occur, only 1% happens out of the hospital). Research shows it comes down to provider care!
Questions from guests:
- What should you do if your DR just says No to a VBAC? What are your options? You are always in control. If you have a provider that is not listening to you or cannot show why they think this is better in writing, then find someone else.
Optimal Care in Childbirh by Henci Goer and Amy Romano (Affiliate link)
If you are in Houston and surrounding areas, check out hhhomebirth.com!