The C-section rate in the United States continues to grow - it increased from 27 percent of all births to 34 percent in just the past seven
years. An unfortunate result of this increase is that many more women will be
forced to undergo a cesarean section for every birth following their first because
current medical standards tend to insist on it. A vaginal birth after cesarean (VBAC) is not impossible, but it may be hard to find a provider willing to do
it and if you are steadfast in having a VBAC there are many obstacles to
overcome. A new review of 60 studies has pinpointed the trends that are
botching women’s attempts at a VBAC.
The reasons to try for a VBAC are numerous. The higher the
number of C-sections a woman undergoes, the more likely she will run into complications
such as uterine rupture, placenta previa, placental accretia and paripartum
hysterectomy. Those risks are in addition to the possibility of developing an
infection or experiencing a hemorrhage, inherent risks with any major surgery. Experts
estimate that anywhere from 60-85 percent of women who’ve had a C-section are
potential candidates for a successful VBAC. Vaginal birth allows for the mother
to recover faster and many women find the experience more rewarding.
Once you are committed to pursuing a VBAC, there are many
things to consider, especially in light of the findings of a new review by the Faculty
of Nursing, Midwifery and Health at the University of Technology, Sydney, New
South Wales, Australia. The researchers discovered a list of factors
contributed to failed attempts at VBAC:
- Artificial means of inducing labor such as rupture of the membranes, prostaglandins, and oxytocin infusion.
- Ripening the cervix artificially by using prostaglandins or transcervical Foley catheters.
- Measuring possible VBAC success rate through methods such as x-ray pelvimetry.
In fact, the researchers found that any attempt to measure
the potential success of a VBAC were not useful.
Although women are encouraged to pursue VBAC’s, there are
specific circumstances that would bar against it. Particular breech positions can
make a vaginal delivery impossible, although some doctors and midwives are
equipped to deliver the most common breech position, where the baby is presenting
feet first. High risk pregnancies and women who have abnormal pelvic structures
will also require a cesarean in many cases.
The results of this report suggest that women who want to
have a VBAC should try to allow labor to present naturally. They should also
take any measurement of potential VBAC success with a grain of salt, except for
cases in which known reasons make vaginal birth impossible.
Are you due to give
birth after a previous cesarean?
Vaginal Birth After Cesarean (VBAC) [PregnancyWeekly]
C-section rate in U.S. climbs to all-time high [USAToday]
Review of 700,000 women reveals factors affecting vaginal
birth after previous cesarean [Eurekalert]
2 comments:
I had an emergency c-section last time (pelvis was too narrow) and the doctor had warned me that it would be difficult to find a doctor who would do a VBAC after that. When he explained the risks involved, I didn't feel it was worth the risk and we'll be doing another c-section in January. I do have a friend who had three other kids naturally after having had a c-section so it's possible, but it's just not that big of a deal for me anymore to push for a VBAC. I just want everyone to be healthy:)
I had emergency c-sec. Also the first time. My son was breeched. He had turned complete upside down. my water had broke..and had stopped contracting progressively, so was induced followed by epidural. I had no complications otherwise. This time around, I am planning for a vbac surgery. It has been difficult to find a dr in west houston. Vbac group on babycenter helped me find dr and they have big support group. Good luck to all out there.
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