Is a VBAC Safe?

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Is VBAC Safe? The data says Yes!Whew! Having endured the recovery from a c-section, you may be looking for a different route to deliver your next child. Cesarean sections involve a great deal more than vaginal births—from the drugs to the body's healing process, c-sections are a major surgical procedure. If you previously delivered a child by cesarean and are interested in a vaginal birth for your next child, you may be wondering if VBAC, or Vaginal Birth After Cesarean, is safe. In most cases to this question, the answer is yes. Numerous current studies support the safety of VBACs when properly supported by medical professionals.

Previously, OBs almost uniformly recommended repeat cesareans for all women; however within the last few years the opinion regarding elective cesareans has changed, and more OBs and midwives support VBACs as a safe birthing experience. Actually, as a community, midwives have long supported the safety of VBACs. On VBAC.com, an evidence-based website that provides information on VBAC, they share that:

Based on a review of 28 high-quality studies, the Coalition for Improving Maternity Services Expert Work Group found that in comparison to care provided by physicians for similar populations, care provided by professional midwives resulted in fewer cesareans, more VBACs, the same or better maternal and perinatal health benefits, and no worse outcomes.

There are many benefits to vaginal birth. Natural births require less healing time for the mother's body, and mothers often find themselves back up on their feet with little or minimal pain. Women also report that their milk arrives more quickly and fully when delivering vaginally as opposed to through cesarean section. Many OBs tend to discourage VBACs because they believe the labor will be more difficult due to scarring on the uterus. However, several recent studies disprove this notion.

In 2000, a team of four individuals, Howard Blanchette, MD, Martha Blanchette, MBA, John McCabe, PhD, and Susan Vincent, RN, presented their findings after a four-year study at the Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society. Their study, entitled "Is Vaginal Birth after Cesarean Safe? Experience at a Community Hospital" evaluated the safety of VBACs. The medical professionals compared the results for 1,481 women; 727 had a repeat cesarean while 754 opted to have a vaginal birth. Of the participating women, the research team found that the neonatal outcomes were similar for both groups. The only noted risk they found was when women who elected to have a VBAC were induced; induction for two women in the study led to uterine rupture, causing neonatal death.

Another study, entitled "Vaginal Birth after Cesarean: A Comparison of Maternal and Neonatal Morbidity to Elective Repeat Cesarean Section" and published in the American Journal of Perinatology, supports VBAC as a safe delivery method. This study, conducted by Nancy L. Eriksen and Louis Buttino JR., concluded that women who opted to give birth vaginally after a cesarean experienced no greater health risks. In this study, the researchers discovered that women who had a repeat cesarean actually "had a higher overall incidence of neonatal morbidity than the VBAC group, but this was not statistically significant." The study compiled data from 152 women; of the 152, 141 qualified for a VBAC and 73 opted to try it. This particular study examined a variety of outcomes including fetal distress and maternal blood loss during delivery. Ultimately, the study's data supported VBACs as a safe alternative to a repeat cesarean.

A third study supporting the safety of VBACs examines one nurse-midwifery's experience with VBACs over a period of five years. Her study actually concludes that this method of birth is better for a woman who previously gave birth through a cesarean surgery. Karin Larson Hangsleben, Margaret A. Taylor, and Nancy M. Lynn, all CNM and MSs, examined the birthing experiences of 53 women. They documented that 83 percent were able to successfully give birth vaginally. In their study, the authors share the specific policies and procedures followed during labor and delivery to encourage successful vaginal births.

Many factors play a role in creating a successful VBAC experience. Factors to consider include finding a knowledgeable medical professional, the amount of uterine scarring as well as the likelihood of induction. The current medical opinion is shifting to embrace giving birth vaginally after undergoing a pervious cesarean section. Recent medical literature supports vaginal births after cesareans as safe for both the mother and baby. Not only do vaginal births decrease the recovery time for the mother, but they are typically less stressful for the baby as well. If you're interested in a VBAC, it's important to discuss this option with your midwife or OB; not all medical professionals are comfortable with supporting VBACs after a cesarean birth. However, with the support of a knowledgeable medical professional, giving birth vaginally after a cesarean is not only completely possible, but safe!

For more information regarding the safety of VBACs, consider visiting one of the following sites:

American Journal of Obstetrics and Gynecology

American Journal of Perinatology

Journal of Nurse-Midwifery

VBAC.com

VBACFacts.com

ICAN of NoVa (International Cesarean Awareness Network, Northern Virginia chapter)