VBAC - Vaginal Birth After Cesarean
Essential new evidence regarding vaginal birth after cesarean.
VBAC, pronounced "vee-back", refers to a vaginal birth after a cesarean section.
Once a woman has experienced a cesarean birth and is pregnant again, she has two possible birth options - a repeat cesarean section or a VBAC.
Both of these options present some risks and benefits and the woman has a responsibility to research the facts, apply them to her circumstances and make an informed choice.
In the USA, cesarean birth ranks as the most commonly performed major operation. About one third of women giving birth experience cesarean sections.
However, current evidence shows that the majority of women can have safe vaginal births after a prior cesarean.
VBAC Safety Statements
- The American Pregnancy Association has stated that 90% of women who have previously had cesarean deliveries are candidates for VBAC and that 60-80% of women who choose a VBAC will succeed in giving birth vaginally.
- In March of 2010, the National Institutes of Health reviewed VBAC scientific data and concluded, "Given the available evidence, trial of labor is a reasonable option for many pregnant women with one prior low transverse uterine incision.".
- Also in March 2010, the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality reported that "VBAC is a reasonable and safe choice for the majority of women with prior cesarean. Moreover, there is emerging evidence of serious harms relating to multiple cesareans."
- On 21 July 2010 the American College Obstetricians and Gynecologists revised their VBAC guidelines stating that "Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans."
- In addition, they also stated that "The College guidelines now clearly say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC." [trial of labor after cesarean]
The College acknowledges that "restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will if, for example, a woman in labor presents for care and declines a repeat cesarean delivery at a center that does not support TOLAC. On the other hand, if, during prenatal care, a physician is uncomfortable with a patient's desire to undergo VBAC, it is appropriate to refer her to another physician or center."
In other words, even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor.
Click here to read the Risks and Benefits of VBAC vs Cesarean
More Pages Related to Vaginal Birth After Cesarean
Vaginal Birth Video Clips - in a hospital setting
Birth Video Slideshows - Twins and Multiples
Child Birth Videos of VBACs (Vaginal Birth After Cesarean)
VBACs after CPD (Cephalo-pelvic Disproportion)
References
The American Pregnancy Association, http://www.americanpregnancy.org/labornbirth/vbac.html, retrieved 29/08/2010
Vaginal Birth After Cesarean: New Insights, Structured Abstract. March 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/vbacuptp.htm
American College of Obstetricians and Gynecologists. (2010, July 21). Ob-Gyns Issue Less Restrictive VBAC Guidelines. Retrieved 29 August 2010, from ACOG: http://www.acog.org/from_home/publications/press_releases/nr07-21-10-1.cfm
American College of Obstetricians and Gynecologists. (2010). ACOG Practice Bulletin No. 115: Vaginal Birth After Previous Cesarean Delivery. Washington DC. http://blog.ican-online.org/2010/07/21/ican-responds-to-new-acog-guidelines-on-vbac/
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