VBACs are Best

A VBAC (Vee-Back) is a Vaginal Birth After Cesarean, a normal practice in other countries than the United States.     I have spoken with many women who have said, "Oh, I wish I could have a vaginal birth," after they had undergone one, or more, cesarean sections. They state their OB "won't let them" have a VBAC, or won't allow it, that they MUST have a repeat cesarean.  Repeat cesareans carry greater risks to the mother than a VBAC and are most commonly performed simply for the fact that the mother has a had a previous c-section.   


Obstetricians have now opened a narrow window to allow women to have VBACS, almost making it impossible for women to fit into the tight constraints, and eventually forcing them into a repeat cesarean.  Generally, the requirements for VBACs are for women to be no further than one week past their due date, have an average size baby, have only had one c-section for a reason other than lack of progress, have their labor and have their birth at a major medical facility with surgical, residency, and in-house anesthesia programs.  These women must also consistently demand VBACs and sign a VBAC release form.

Truth be told, a VBAC is much safer than a repeat c-section and the risks associated with an abdominal surgery.  The American College of Obstetrics and Gynecology has ruled that unless there is a specific medical reason for a repeat cesarean, policies should allow a woman to have a vaginal birth.  However, studies show that most Obstetricians will not encourage VBACs, find excuses to perform c-sections late in pregnancy, or take the opinion that c-sections must always be performed subsequently to the first.  Henci Goer, author of The Thinking Woman's Guide to a Better Birth, states the newest reason to not allow women to have a VBAC is "inability to perform immediate emergency cesarean delivery because of unavailable surgeon, anesthesia, sufficient staff, or facility."  A woman choosing a VBAC should be laboring in a hospital with these amenities.  Henci Goer also points out, "The general population has about the same potential for an emergency in labor as the potential for the uterine scar giving way (0.04-1%).  If it isn't safe for VBAC labors in hospitals that cannot meet these criteria, then it isn't safe for anyone to labor there."

What can a mother do to demand a VBAC?  After all, she has the right to decide her medical care, even though doctors believe it isn't.  ICAN, the International Cesarean Awareness Network, has a wonderful resource to help women have the VBAC they desire.  Check out their website at www.ican-online.org and their Q & A "What to do if your Hospital/Doctor has "banned" VBACs".  


I highly recommend that every expectant mother read Henci Goer's book The Thinking Woman's Guide to a Better Birth.  This book is a wonderful, unbiased resource for labor and modern medical interventions.