The sunshine streams gently through the window. Dawn is breaking and a mother is gently guiding her baby into the light. Lace curtains flutter with the spring breeze. The smell of lilacs waft through the window. Dad watches in awe – say’s, “You just worked harder in 7 hours than I have all year.” The midwife stands ready, prepared for whatever… or nothing… that might need her attention. Siblings wait outside the door hoping to soon hear the coo of their new brother’s cry.
And it comes. Lovely water birth – vaginal birth after cesarean – the birth everyone told her she couldn’t have. After two cesareans she was told “Your chances of a vaginal birth are zero.”
She beat the odds. But she wasn’t lucky. The research shows the risk for uterine rupture when attempting a vaginal birth after cesarean is somewhere around 3%. Of those 3% an unknown number of them will result in a fatality of the baby and life threatening hemorrhage in the mother. The risks are certainly real but often over-stated. Hospital policies usually hold the trump card and women are increasingly being forced to look at out-of-hospital options if they wish to attempt a VBAC. To illustrate the ridiculousness of some policies – the mother described above had 2 cesareans and then 2 subsequent vaginal births. She was THEN (with her 5th pregnancy) told she was now allowed a vaginal birth since she had previous given birth by cesarean. No mention to her of the data showing her risk of uterine rupture after 2 VBAC’s decreased to the percentage that every pregnant woman faces. No mention of the fact that POLICY dictated this physicians statement of her odds and not research.
If you are faced with making a decision regarding a vaginal birth after cesarean – follow your instincts. The benefits are numerous and the risks of repeat cesarean are often not mentioned or are understated by care providers. There are many online resources that can bring you to the data you need access to in order to make an informed decision about your birth.
Look for local ICAN (International Cesarean Awareness Network) chapters with monthly meetings for support from other mothers. Local breastfeeding & mom’s groups can also be venues for finding an out-of-hospital providers or freestanding birth centers in your area. Whatever decision you make – make in an informed one. Your decision deserves the respect and support of your care provider. Don’t settle for less.
