7 Things To Know About VBACs

by Wendy Wisner
Originally Published: 
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First, let me make something abundantly clear. However you birth your baby, you are an incredible, strong, beautiful mama. Birth matters, and every mother should be able to feel like they are respected, heard, and treated kindly in the delivery room. But birth is also unpredictable, messy (literally), and just doesn’t always go according to plan.

So, however it went down for you—including whatever choices you did or did not make—the most important thing is that you and your baby are well and healthy. Full stop. End of story.

All that being said, if your birth ended up with a C-section for whatever reason, you might be considering trying a VBAC (Vaginal Birth After Cesarean) for your next birth. And I’m here to tell you that yes—unless there is something medical that prohibits you from doing so—you absolutely consider it.

Unfortunately, it can be an uphill battle to find a provider who will fully support you in this endeavor (more on that in a minute), but there are several compelling reasons to push for the opportunity. Not only that, but it turns out there are some strong stats on your side in terms of safety, which is obviously super-duper important.

Ready to get your VBAC on? Here’s what you need to know:

1. The majority of women can have a successful VBAC.

Lots of moms wanting to attempt VBAC are concerned that they won’t be successful. But there is some good news on that front: the overwhelming majority of women who attempt a VBAC actually are successful.

“Currently, women who attempt trial of labor after cesarean delivery (TOLAC) have a 60 to 80 percent success rate of achieving a vaginal birth,” wrote the American College of Obstetricians and Gynecologists (ACOG) in a 2017 press release.

Awesome, right? For this reason and more, ACOG and other major health organizations highly recommend that healthy women attempt VBAC whenever possible.

2. Your risk of uterine rupture is very small.

It is totally understandable that you would be concerned about your uterus rupturing during a VBAC. After all, you likely have a visible scar to remind you of where your previous surgery took place. But your risk of uterine rupture is actually very small, especially if you are being cared for by skilled practitioners.

A 2012 study, for example, found that uterine rupture is an extremely rare event, occurring in only 0.2% of VBAC attempts. Those are some really comforting stats, if you ask me.

3. VBAC is often safer than a repeated C-section.

It’s important that you keep in mind that C-sections—especially repeated ones—are not without risk. As a 2015 study from the National Vital Statistics Reports points out, repeated C-sections increase your risk of ruptured uterus and unplanned hysterectomy. C-sections increase your risk of maternal mortality as well.

This one of the reasons that ACOG recommends VBAC for all eligible women.

“VBAC allows women to avoid major abdominal surgery and lowers their risk of hemorrhage, blood clots and infection,” writes ACOG. “It also shortens the recovery period and reduces women’s risk of experiencing maternal morbidity or mortality during delivery in a future pregnancy due to repeated C-sections.”

4. It can be hard to find a provider who is supportive of VBAC.

So now that you’ve got all these stats on your side, you’d think it would be easy to find a provider who will happily try a VBAC with you. Well, this is where things get a little tricky. It turns out that it can be hard to find a doctor or midwife who is on board with the whole thing. In fact, Dr. Aaron Caughey, an OB and researcher, tells The Wall Street Journal that as many as half of all hospitals in the U.S. don’t offer VBAC as an option.

According to ELLE, reasons for this include the fact that even though the ACOG guidelines were changed to recommend VBAC in 2010, not all hospital have updated their policies. And, of course, there’s a fear of litigation, which is complicated by the fact that OB’s are sued for malpractice much more frequently than other types of doctors.

That doesn’t mean that doctors who will perform VBAC aren’t out there, but just that you have to seek them out. It can be helpful to get VBAC stats for various hospitals in your area. Chances are, hospitals that have higher rates of VBAC also have providers who are on board with the whole thing. Asking for a personal recommendation within your community can be really useful as well.

5. You’ll need to arm yourself with facts and advocate for your needs.

Even once you’ve found an obstetrician willing to try a VBAC with you, you will likely still need to advocate for yourself throughout the process, as myths about VBAC still abound. It can be helpful to get your partner on board too, and/or hire a doula or birthing assistant who will help you advocate.

Jessica Smock, a mom of two from New York, shared her VBAC/advocacy story with Scary Mommy:

“I had an emergency C-section with my son,” she says. “When I was pregnant with my daughter, I was told that a VBAC would be highly unlikely (primarily due to my age — 40) and repeatedly pressured at appointments to schedule a C-section right at 39 weeks. I basically refused, and my daughter was born in a quick (90 minutes) and very easy labor exactly at 39 weeks. So, so glad that I pushed back against the doctors.”

Smock is one of many kick-ass moms who haven’t taken no for an answer when it came to their decision to try a VBAC. It can be helpful to find more stories like hers to arm yourself with during your journey. The ICAN (International Cesarean Awareness Network) blog is a great place to start.

6. Your recovery time will likely be easier with a VBAC.

Besides all the awesome benefits of the birth itself, your postpartum recovery will likely be easier if you have a VBAC. You will probably have a shorter hospital stay, and you will also not be recovering from major surgery, which is huge. Of course, vaginal births aren’t always a walk in the park either, but being able to get up freely to pee or shower after birth is a major plus.

7. No matter how your birth turns out, you are amazing and strong.

Not all women can have a VBAC (there are definitely medical conditions that preclude trying a VBAC, which is why you will need to consult in detail with your healthcare provider). And some women—no matter how hard they try—do not have successful a VBAC and end up with repeat a C-section.

There is no shame in any of that. There is a reason why C-sections exist, and that is to save lives. It’s natural to feel disappointed and maybe even like your body failed you if you end up with a C-section after a VBAC attempt. But you didn’t fail. In fact, C-section moms are some of the strongest moms out there because they went through major surgery to usher their little ones into this world.

Again, however you bring your baby into this world, you are a badass hero. For real. And if you choose to attempt a VBAC, you should know that not only is it something you should feel empowered to try, but the chances are high that you will be successful.

You will have to do a little more research and advocating than you might feel comfortable with, but you can consider that an opportunity to learn about how your body works—and self-advocacy is always a good thing to practice.

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