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The reason I became passionate about vaginal birth after cesarean is because I personally had a cesarean. Afterwards, I knew I wanted to try to have a vaginal delivery since I didn’t get a shot at it the first time. I was shocked by how little people knew that VBAC was even an option. Did you know that 40% of hospitals in the United States ban VBAC? How can facilities ban a type of birth? The most recent research shows that attempting a trial of labor after cesarean that leads to VBAC is a safe and reasonable option. Why has there been such a disconnect with the research and hospital policies? Luckily, many hospitals are changing to allow women to have the option to TOLAC. If this is something you or your patient are considering, here are some important questions to ask:

Why would you or your patient want to pursue a VBAC? 

• If you have a desire for a natural birth 
• Shorter recovery period than cesarean
• Lower risk of complications including increased blood loss, infection and scar tissue
• Lower risk for future complications with pregnancy related to cesarean, such as placenta previa or accreta

What are the risks of having a VBAC?

Although rare, less than 1% of a TOLAC can lead to uterine rupture. This can be life threatening to the mother and fetus. In this case an emergency cesarean is needed to prevent loss of organ and life.

What are the chances of you or your patient having a successful VBAC? 

This can be a complicated question. A good starting point is asking why the cesarean happened? Have you or your patient had a previous vaginal delivery? Was there a medical indication such as severe preeclampsia? Was baby breech? Did you or your patient ever fully dilate? Even though there are many variables that can change your percentage success rate, research shows about 70-80% chance of success. Those are some good odds!

How can you increase you or your patients chances of having a successful VBAC? 

There is no magic formula. The only predictable aspect of birth is that birth can be unpredictable. However, having a supportive team is probably the most important. Try to find someone whose views on birth align with yours and has your best interests at heart.  What are some questions to ask your provider? 

• What is your practice for TOLAC?
• What is your cesarean rate?
• What is your VBAC success rate?
• Will you let me go past my due date?
• Will you augment my TOLAC?
• What is your fetal monitoring policy for TOLAC & do you have wireless monitoring available?
• What is your practice if there is a suspicion of fetal macrasomia?
• What is your practice for laboring with waters broken over 24 hours?
• Do you offer family centered cesareans

These are all things I learned on my mission to TOLAC and VBAC. Your birthing rights are worth fighting for!

Written by Kinsey from Elkhorn, IA. Kinsey is a Certified Still Birth Day Doula. If you would like to reach out to her, check out her IG @thehyggesoula or Facebook facebook.com/thehyggedoula

Want some more information? Here are some great resources for birth workers and birthers regarding TOLAC and VBAC.

Do you love birth? Heck yeah you do!

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