By Maria Siu, DO, FACOG, Obstetrician/Gynecologist
Between 1970 and 2016, the Cesarean-section (C-section) rate in the United
States increased from 5% to 31.9%. The belief in "once a C-section,
always a C-section" is one of the reasons that the C-section rate
has increased. However, in 2010, the National Institutes of Health recognized
that trying vaginal birth after C-section was a reasonable option for
many women with a previous C-section.
The benefits of a successful vaginal birth after C-section include avoiding
a major abdominal surgery, lower risks of bleeding, infection, fewer complications
for future pregnancies, and also a faster recovery compared to mothers
who had an elective repeat C-section. Without C-section incision pain,
patients can also take care of their little ones more comfortably.
It is important to remember that trying vaginal birth after C-section (VBAC)
is not risk-free. The major concern for VBAC is uterine rupture or separation
of a previous uterine scar. When uterine rupture happens, that can put
the mother and the baby at risk. Emergent C-section is required at this
time. Thankfully, the risk of uterine rupture is less than 1% overall.
So, how do you know if you should try VBAC?
Patients who have delivered vaginally before a C-section are good candidates
for VBAC. As your body has successfully done a vaginal birth before, the
labor process usually goes faster and is more likely to go into a successful
VBAC. Patients who had a C-section because their baby did not come down
during labor may not be the best candidates for VBAC.
There are many other factors to consider if you should try VBAC or not.
Always discuss your options of trying VBAC versus having a repeat C-section
with your doctor.
Does Pomona Valley Hospital Medical Center (PVHMC) support VBAC?
Yes! Not every hospital can perform VBACs. Hospitals that offer patients
the option for VBAC are required to have an obstetrician, an anesthesiologist,
a neonatology team, and nursing/surgical staff on-site 24/7. PVHMC meets
these requirements and provides comprehensive care for patients who decide
to try VBAC.
Should you decide that you want to try VBAC and come to PVHMC for labor,
you and your baby will be monitored continuously to ensure there are no
signs of uterine rupture. During the labor process, if you feel labor
is not going as smoothly as you’d like, you can always talk to your
doctor about having a repeat C-section procedure. After all, the safety
of you and your baby, as well as your delivery experience, are our highest
Reference: Vaginal Birth After Cesarean Delivery. ACOG Practice Bulletin.
Number 184, November 2017.