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VBAC Information

If you have had a cesarean birth and are pregnant again, you may be considering a VBAC: vaginal birth after cesarean. Some women choose to VBAC in the hospital with an OB, others choose HBAC (home birth after cesarean), and VBAmC (vaginal birth after multiple cesareans) is an option for still other women, and some women will have another cesarean, whether planned or unplanned. Whatever your personal decisions, ICAN is here to help you find complete and accurate information about VBAC and repeat cesarean, so you can make the best decision for yourself and for your baby. 

In March of 2010, the National Institutes of Health convened a panel to assess available data relating to VBAC. The panel concluded that, “Given the available evidence, trial of labor is a reasonable option for many pregnant women with one prior low transverse uterine incision. The data reviewed in this report show that both trial of labor and elective repeat cesarean delivery for a pregnant woman with one prior transverse uterine incision have important risks and benefits and that these risks and benefits differ for the woman and her fetus.” They went on to say, “One of our major goals is to support pregnant women with one prior transverse uterine incision to make informed decisions about trial of labor compared with elective repeat cesarean delivery.” To read the entire panel statement, please visit: Vaginal Birth After Cesarean: New Insights Final Panel Statement.
http://consensus.nih.gov/2010/vbacstatement.htm

It can be difficult to sift through the NIH data and determine how it applies to our own pregnancies and births. A group of maternity care professionals and VBAC advocates came together to create an online resource guide titled “A Woman’s Guide to VBAC” http://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/ which addresses many common questions women may have about their birth choices following a cesarean delivery.

Quick facts about VBAC:

2007 Cesarean and VBAC rates

United States

Colorado

Cesarean Section

31.8%

25.8%

VBAC

8.3%

16.2%


Uterine rupture

(US rates unless otherwise noted)

Without labor (scheduled repeat cesarean):

0.2%

Average rupture risk in all VBAC labors:

0.7%

Spontaneous VBAC labor:

0.4%

Spontaneous VBAC labor, augmented with pitocin:

0.7%

Pitocin induced VBAC labor:

1.1%

VBAC Labor induced with prostaglandins:

2%-8% (higher rates with use of cytotec)

Risk of rupture in an unscarred uterus

0.012%  (in developed countries; 0.07% worldwide)


Risk of delivery complications (per 100,000 births)

VBAC

RCS

Maternal mortality

4

13

Hysterectomy

157

280

Deep venous thrombosis

40

100

Placental abnormalities

 

significantly increase with multiple cesareans

Fetal mortality

130

50*

Brachial plexus injury

180

30**

*The mortality rate for VBAC is similar to the mortality rate for first-time mothers who deliver vaginally. Additionally, the numbers here are at delivery and represent only a small fraction of deaths from all causes. The overall mortality rate is 1,073/100,000. 

**In spite of the difference in rate of injury, no difference in long-term neurological impairment was noted

Birth