Vaginal Birth After Cesarean
By Peggy DeZinno
Have you had a Cesarean Section
for the birth of your baby? Do you know someone
who has? Have you heard the phrase, "Once
a Cesarean, always a Cesarean"? Do you think
If the answer to any of these questions
is "yes," you will want to know more
about Vaginal Birth After Cesarean, or "VBAC"
Here are a few facts about Cesarean
Section that you might not be aware of:
Cesarean Section is a
major surgical procedure.
In many cases it can be
lifesaving if there is a good medical indication.
The rate of Cesarean has
increased from 5% in 1970 to 24.7% in 1988, and
has dropped slightly to 20.5% in 1995.
In the U.S., Cesarean
Section has become the most frequently performed
major operative procedure for childbearing women.
Cesarean Sections cost
more than vaginal births in terms of higher hospital
and doctor costs and fees, and longer hospital stays.
The World Health Organization
(WHO) tells us that the Cesarean Section rate should
not be more than 10-15%. On the other hand, women
who have a VBAC have a quicker recovery. Having
a proven successful VBAC sets the path for further
Across the country, there
is an initiative to lower the Cesarean Section rate
and raise the VBAC rate. "Cycles for Change"
is the catchword that describes efforts to reach the
goal of a 15% Cesarean rate and a 65% VBAC rate in the
next year. "Once a Cesarean, always a Cesarean"
no longer holds true. In fact, women with two previous
Cesarean Sections can now labor. The only absolute contraindication
specific to a VBAC trial of labor is a previous vertical
incision on your uterus.
What can you do to increase the
chances of having a VBAC?
First, expect a vaginal
Discuss with your caregiver
the circumstances surrounding your previous pregnancy
and delivery. Try to determine what could be changed
to improve your chances of having a VBAC;
Find a supportive doctor/nurse-midwife.
Ask what the C/Section rate is in the practice;
Know that a VBAC is possible;
Seek prenatal care early;
Have an uncomplicated pregnancy;
Eat a well-balanced diet;
Find a safe prenatal fitness
program, i.e. Dancing Thru Pregnancy®; Attend
a VBAC Class early in your pregnancy to learn more
about your options for a successful VBAC;
When you are in labor,
use all the comfort measures that you learned about
in your classes, including coming to the hospital
in active labor, staying upright and out of bed,
using all comfort measures at your disposal, including
a Birth Ball, aromatherapy acupressure, showers,
slow dancing, frequent position changes, and more;
Learn as much about birth
as a normal process as you can;
Believe in yourself. When
laboring, surround yourself with people who believe
the same as you do.
Read about VBAC, especially
if you are thinking about having a repeat Cesarean
Section. Birth After Cesarean, by Dr. Bruce Flamm,
is the best book on the subject.
To join the initiative "Cycles For Change"
and be part of a growing team that is working very
hard to make birth more of a process and less of a
medical event, contact the hospital or birthing center
at which you will give birth.
Peggy DeZinno is the coordinator of Women's Education,
Life Learning at Yale New-Haven Hospital. She and
her husband live in Prospect with their three daughters.
NOTE: This information should not be used as
a substitute for the medical care and advice of your
personal healthcare provider.
home | shopping
| shows | tips
& articles | enter
free guide |advertise
| contact us
© The Baby and Toddler Guide