quick clicks

iparenting canada articles

iparenting canada q&a

community & groups

research baby names

prepare a birth plan

content channels

ip channel rss feeds

read birth stories

read parenting stories

recommended books

e-newsletters

safety recalls

ip diaries

ip store

mom of the month

dad of the month

editor's letter

letters to the editor

Can You Really VBAC It?

Pursuing a Vaginal Birth After Cesarean

By Shel Franco

In addition to the type of incision, the type of labor may also affect the risk of rupture. Labor can be spontaneous, beginning on its own, or it can be induced with the help of drugs. Some recent studies show uterine ruptures are less likely with spontaneous labor.

In the United States, most women use obstetricians for care during pregnancy, labor and delivery. Board-certified obstetricians follow VBAC guidelines created by the American College of Obstetrics and Gynecology (ACOG). According to Dr. Klein, current ACOG guidelines mandate that women attempting a vaginal birth after Cesarean have no more than two prior low-transverse Cesarean deliveries, have clinically adequate pelvises and have no other uterine scar or previous rupture. The guidelines also require the immediate presence of a physician who is able to monitor and perform an emergency Cesarean delivery. As a result, anesthesia must be available, along with the personnel to administer it.

To some women's dismay, most doctors will not negotiate where these guidelines are concerned. Dr. Klein explains why doctors must comply. "It is at their patient's medical and their medicolegal peril to vary."

In order to circumvent the guidelines, some women turn to certified, licensed or lay midwives. A certified nurse midwife (CNM), under the direction of an obstetrician, will still be subject to these rules, but the requirements to VBAC with an independent midwife vary.

Peck accepts women with prior Cesareans as homebirth candidates, if they are in good overall health and have a horizontal incision scar without any evidence of separation. When there is separation or weakness at the old incision site, Peck says vaginal birth may be attempted at the hospital, but not at home.

Want to see more?

• Should Women Having Large Babies Expect to Deliver by Cesarean?
• Why Hire a Doula?
• Could I have a VBAC?
• What are the risks of a VBAC?

Post As:
Enter your comment below:
Title
Comment Text
CAPTCHA
Please note that any comments submitted become the property of Disney Family / iParenting and can be edited and posted at our discrection.