This is Episode 120 of the Juna Women Podcast, Vaginal Birth After Cesarean (VBAC).
The Juna Women Podcast is a weekly discussion where Juna Founder, Sarah Kuhn, talks to Moms about their health, work, parenting, and all the different ways they’re keeping it together.
What is a VBAC?
In this episode, Sarah talks with Meagan and Julie from The VBAC Link. Meagan and Julie are Moms, doulas, and experts on VBACs.
Their goal is to provide woman with the information to advocate for themselves and the birth experience they want to have.
What is a vaginal birth after cesarean (VBAC)?
A vaginal birth after cesarean, or VBAC, is when a woman has a vaginal birth after having one or more cesarean births.
There is a lot of misinformation and misunderstanding about VBACs amongst providers. This can leave parents feeling lost and confused.
Who is and who is not a candidate for a VBAC?
About 90% of pregnant women are candidates for a VBAC, but only about 10% believe they are.
You are a good candidate for a VBAC if you have:
- gone into labor naturally
- had a previous vaginal birth
- the reason you had a cesarean was because a breech baby, or your baby was too large
You are a potentially risky candidate for a VBAC if:
- you have placenta previa
- your baby is transverse or not willing to turn
- there is a serious issue with Mom where laboring is not physically possible or dangerous
Why is it hard to find providers that support vaginal birth after cesarean?
Often providers fear the risks associated with VBACs, even though they are small.
Additionally, they may also have issues with their insurance companies. There was a time where insurance companies would not support parents going for a VBAC.
Also, in the mid 1990s providers were using a medication to induce VBACs. It caused uterine ruptures to happen at a much higher rate.
As a result, some older providers may be dealing with stress and trauma associated with VBACs.
What are the risks associated with a vaginal birth after cesarean?
The single biggest risk with a VBAC is uterine rupture.
Most research suggests the risk of uterine rupture is 0.5% to 1%, or 1 in 200.
Uterine rupture is spontaneous tearing of the uterus that may result in the fetus being expelled into the peritoneal cavity.
About 1 in 16 uterine ruptures are catastrophic, which can be a risk to baby’s life. This happens approximately in 1 out of every 1500 VBACs.
Other risks of VBACs include vaginal or rectal tearing.
That being said, the risks of both cesarean births and vaginal births can be mitigated with proper risk management, care, and attention.
What are the risks of repeat Cesareans?
The risks of hemorrhaging can be higher during your second C-section.
Secondly, women are also prone to lose more blood during a cesarean as compared to a vaginal birth.
Lastly, about 1 out every 100 c-sections result in baby being cut and needing stitches.
There are pros and cons to both VBACs and Cesareans.
Find a provider to help minimize the risks of VBACs
In order to maximize your chances of a successful VBAC, you’ll want to find a provider who supports your journey. Here are some of our favorite tips:
1) Ask open ended questions.
a) What are your thoughts on a VBAC?
b) How often do you support VBACs?
c) At what point do you suggest a cesarean?
2) Have the conversation before your examination.
It can be intimidating to advocate for yourself while you are in a gown or feeling vulnerable. Have the conversation in the Doctor’s office in plain clothes. Be ready and informed.
How is the birth for a VBAC different?
With an VBAC in general, providers have continuous fetal monitoring.
One of the first indications of uterine rupture is fetal distress.
In the case where there is a baby that is really struggling and not recovering, that can be a sign of increased or decreased heart rate and baby may be in trouble.
How long should you labor at home with a VBAC?
You can definitely labor at home, but your provider may want you to come in a bit earlier than a non VBAC mama, so they can help mitigate risks.
However, if you are looking for a hands off delivery, you will want to see what your options are for an out of hospital delivery.
For more on VBACS, please listen to the entire podcast episode with Julie and Meagan.
They break down the pros and cons of having a VBAC, teach you how to advocate for yourself, and share their personal stories which led them where they are today.
Get In Touch With Meagan and Julie
Julie and Meagan are VBAC moms, birth doulas, and educators whose mission is to make birth after Cesarean better.
They provide evidence-based education, support, and have a community of like-minded people to help you on your journey. They are the VBAC experts.
If you are feeling lost or confused about all the conflicting VBAC information, please reach out.
They break down the medical talk and present it to you in a simple way so you can feel confident and prepared. You deserve the best information, and they are here to give it to you.
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