Previous Post Next Post

Pregnancy

Brought to you by

5 VBAC Myths Debunked

By Danielle |

When a lot of women think about Vaginal Birth After Cesarean, also known as VBAC, they think about old, outdated information that has been passed around in the last decade as the rate of vaginal births after previous cesarean deliveries has dropped drastically.

This trend has been very concerning for most in the childbirth field, from medical professionals to those of us like myself who work as support or as childbirth educators. For myself, as a mother who has had two previous cesarean sections, one being a long labor trying to have a successful VBAC, this has become a passion of mine.

Education is the key to making safe choices in your medical care and childbirth, especially after having a previous cesarean delivery.

Myth: Once a Cesarean, Always a Cesarean.

While this used to be a common myth, the tables have turned with more research being done. The safest option for the majority of women with a previous cesarean delivery is labor and a vaginal delivery when possible. After one surgical delivery, there are risks in any future pregnancy, but learning and weighing the risks is most important.

Risks of VBAC: Uterine rupture (0.6 percent), and failed VBAC leading to another cesarean section (VBAC is estimated to be between 60-80 percent successful depending on the birth setting).

Risks of a Repeat Cesarean: Infection, increased blood loss, decreased bowel function, respiratory complications, longer hospital stay, longer recovery time, reactions to anesthesia, the risk of additional surgeries, adhesions, future infertility, increased risk for placenta problems in future pregnancies, complications to the baby, and maternal death.

Myth: VBAC is illegal.

This is 100 percent incorrect. VBAC is legal throughout the United States, even in areas where hospitals have “banned” the procedure. Unfortunately, with all the incorrect information out there flying around through rumor and word of mouth, there are a lot of women who think it is not legal.

Myth: VBAC is not an option if you have had more than one previous C-section delivery.

As most have already learned through my journey seeking a VBA2C, also known as Vaginal Birth After Two Cesarean sections, there is a lot of information out there that shows a trial of labor after two previous C-sections is a safe and viable option for low-risk women. In fact, in light of recent studies published by The American College (Congress) of Obstetricians and Gynecologists, the organization, better known as ACOG, has changed their recommendations for VBAC and VBA2C to say both are reasonable options for informed women.

Myth: You cannot VBAC twins.

Another common myth, since so many women who carry twins today are often having cesarean deliveries. In the ACOG guideline changes I talked about above, the Physician Trade Group also changed the recommendations for women pregnant with twins with a previous cesarean section delivery. The International Cesarean Awareness Network has a lot of great information and resources on VBAC with twins.

Myth: Labor induction for VBAC is 100 percent safe.

While sometimes labor induction is medically necessary, it should be avoided at all costs in women with previous uterine surgery, including a cesarean section. The stronger contractions produced by the drug can greatly increase a mother’s risk for a uterine rupture. This is also the case in women that do not have any previous cesarean births.

If you have a provider who suggests induction in VBAC, seek a second opinion and make sure you research and feel comfortable with this decision, as it certainly is risky.

More on Babble

About Danielle

danielle

Danielle

Danielle Elwood is a straight-shooting Florida based mom of three and emerging indie author. Read bio and latest posts → Read Danielle's latest posts →

« Go back to Pregnancy

Use a Facebook account to add a comment, subject to Facebook's Terms of Service and Privacy Policy. Your Facebook name, profile photo and other personal information you make public on Facebook (e.g., school, work, current city, age) will appear with your comment. Comments, together with personal information accompanying them, may be used on Babble.com and other Babble media platforms. Learn More.

26 thoughts on “5 VBAC Myths Debunked

  1. Jessica says:

    This is an excellent article!
    With my first pregnancy I was scared to death of labor and I did nothing to educate or prepare myself. I opted for every needless intervention and had a c-section happy doctor, that combo of course resulted in my daughter being born by cesarean. Afterwards I really regretted missing out on what I could’ve had and decided to confront my fears and educate myself on all things labor. Before we even conceived our second I had researched VBACs and read everything I could find pertaining to the subject, the pros as well as the cons.
    I went back to my doc for a consultation regarding vbac and he said I could attempt TOL but only with induction ( so that he could “schedule” himself to be present). He was very negative and told me my pelvis arch was too narrow, I could try but I would probably fail. By this point I knew that if I were to attempt TOL my best chance to be successful would not be under his care. In my mind I was disgusted, he never once gave me the risks of a cesarean or the risks of induction and seemed more concerned about his schedule then the well being of my body and my baby.
    After this I consulted with a doula who referred me to several VBAC friendly doctors in the area. I consulted with the first name she had given me and immediately knew I had found the right doctor. This doctor was so compassionate and really took her time with me (with each patient actually, so much so that my appointment time was always a long wait because she was always running behind). She even gave me her personal cell phone number, I was shocked that she would do that!!! She avoided interventions unless absolutely necessary and trusted my body to do what it was designed to do.
    On April 27th, after 45 minutes of pushing I successfully delivered my handsome son into this world!
    I was so excited and pleased, it was a redeeming experience.
    So thank you for being an advocate and an encouragement for those women who are seeking out their options.

  2. Jamie says:

    Myth: You can not VBAC a large baby.
    My daughter and I are living proof that you can VBAC a large baby. She weighed in at 10.1 pounds when she was born. I had a very successful VBAC with no complications.

  3. Amy says:

    I would be very interested in your sources regarding Myth 5. While I agree that induction is not 100% safe, I completely disagree that an induction greatly increases the risks for the mother. While prostoglandins are contra-indicated, the use of pitocin is not. This is something that the ACOG has stated in a practice bulletin. Additionally, there are other ways to induce a VBAC including the use of a foley bulb to manually dilate them cervix. While I feel that the rest of the article is fairly accurate, you have not only failed at de-bunking myth 5, but you are contributing to the myth that it is unsafe to induce a VBAC patient.

  4. Kirsten says:

    Meh- I think this should have been more thought out- what are the biggest myths about VBAC? I don’t think these are it….

  5. Danielle625 says:

    @Amy, the resources I used for myth #5 besides personal experience through my own care going through a trial of labor after a previous cesarean under the care of a midwife who was not allowed to use augmentation of pitocin, or prostoglandin’s per hospital policy, but it also decreases the likelihood of vaginal delivery per Outcomes of Induction of Labor After One Prior Cesarean February 2007 in Obstetrics & Gynecology.
    More information also came from the website VBACFacts.com as well as the American Pregnancy Association which cites ACOG, Midwifery Today, Winter No 36, page 47 for this information.
    I hope that clears that up for you.

  6. Danielle625 says:

    @Kirsten – These myths came from my readers. I asked people not only on twitter, my facebook fan page, and the website CafeMom.com to list what they personally thought the biggest myths on VBAC were. And these were the top 5 myths people came back with when I asked around. If you would like to include more myths, or ones you feel to be more important, feel free to comment with them!

  7. Amy says:

    Well first, I’m sure that I don’t need to tell you that your personal experience is jut that, personal. Just because your hospital does not allow the use of pitocin, it does not mean that is the case for all hospitals, nor is it general VBAC policy. My hospital does allow the use of pitocin. I personally had pit during my VBAC. The use of pitocin is not contra-indicated. This is clearly outlined in the ACOG Practice Bulletin that you referenced. I have read all the sources you indicated. Sure, the Midwifery Today article references a study that showed the risk of rupture of 2.3%, they go onto admit that the study was so small that it is statistically insignificant. On top of that, they also repeatedly mention that the use of pitcoin at “high infusion rates put women at a greater risk”. The key here is the high rate of infusion. Minimal to moderate use of pitocin and close monitoring is perfectly acceptable. I wonder why you didn’t examine the Lydon-Rochelle study from 2001. It indicates that the overall uterine rupture risk is .5%. Add in the use of pitocin, the risk increases to .77%. This is hardly the great increase that you so boldly state. It is still below the risk of multiple labor risks such as cord prolapse.I’m quite dismayed that you did not mention the use of a foley bulb to begin an induction. It’s becoming a fairly common practice, particularly for VBAC patients. It is quite effective and in addition to manually dilating the cervix, it often jump starts labor itself. And while I agree that every VBAC patient needs to educate themselves regarding induction, to imply thar a doctor who suggests an induction is overly risky, is not only irresponsible, but only it is only serving to perpetuate the myth that you are claiming to debunk.

  8. danielle625 says:

    Well Amy, you are certainly entitled to your opinion and I will not go back and forth on this. I am not a medical professional, and I am not giving anything more than my personal opinion from my personal experience in my opinion piece. :)

  9. KK says:

    Induced VBACs are actually not that rare. Quite a few practitioners will use a Foley catheter or very low dose pitocin augmentation. The uterine rupture risk is elevated with pitocin use, but it is still incredibly low. Only prostaglandins are truly contraindicated. While I agree that a spontaneous labor is preferable, induction is a reasonable choice when there is a medical reason for it and the only other option is a repeat Cesarean.

  10. labortrials says:

    The reason pitocin is not a great idea is because it causes the uterus to contract more strongly. This puts more stress on the scar. If you want to know more about the risks with regard to induction and augmentation in VBAC clients, I recommend consulting Marsden Wagner’s writings.

  11. Kayle says:

    I thought this was a great article. There is so little out there for Mom’s who wanna go VBAC. Thanks for your point of view :D

  12. Joy Szabo says:

    I can attest to that….. there are far too many lies being told to mamas

  13. Buzzy says:

    Awesome article. And your POV is spot on IMO.

  14. Bettina says:

    thank you for this valuable information . . . more myths need to be debunked!!

  15. Mrs4444 says:

    They almost killed me on the table during my cesarean to deliver my son (overdose of anesthesia). Three years later, I had an absolutely perfect vaginal delivery with my daughter. So glad I was able to experience the other end of the spectrum :)

  16. Kati says:

    I had an amazing twin VBAC (using hypnobabies), and it was unmedicated! It can be done. Vaginal delivery has it’s own surprises, but the recovery is so much better and shorter than a cesarean recovery.

  17. Nicole @SistaMidwife Deggins says:

    This is a GREAT article with clear information. Thank you for shattering these myths. Women need to know their options and understand that a VBAC is a safe choice for most women.

  18. Joy Szabo says:

    This is so true

  19. Crystal says:

    Pitocin is risky for everyone! Of course it’s not a good idea for vbac… It increases the risk of fetal distress & c/s, both you would want to avoid if you are trying for a vbac. I think (as a midwife) in the hospital setting for a medical need (not just post-dates or “big baby”) it could be used as a last ditch effort to vbac. But in my experience, vbac usually work the best when left uninterferred with. btw, my personal vbac rate is 93%. Also a jump from .5-.77% is a 25% increase and significant…still extremely rare, but worth knowing about.

  20. Mommy2boys says:

    I think this is a good opinion piece! =) Though, I like hearing anything supporting vbacs and sharing information/experiences about them. After my water had been broke for 12 hours, with no consistent contractions, my doctor and I decided that a little pitocin could possibly help jump start labor. She was very cautious with it, starting very slowly and only increasing the dose very slowly. Once my labor kicked in I was taken off it- so 25 hours from water breaking to deliver I had my successful vbac! =) I know there are risks with pitocin, but there are risks with everything really.

  21. Barb says:

    I had a vba2c at 38 years old successfully. Completely un-medicated birth :)
    thanks for the article.

  22. PreggyMomma2twomonkeys says:

    I know someone personally who had a VBAC and got the epidural. This meant she now needed pitocin to augment her labour and resulted in a uterine rupture. Pitocin is NOT conducive to a healthy labour unless absolutely necessary but basically only increases fetal distress so…..

    I have had my own natural VBAC (no pain medication, no augmentation) and gave birth to a 9lb 6.5oz baby with no issues. I had a doula which made a massive difference between my two births and I went with midwives who happily accepted my intended birth plan. A few changes had to be made but in the end my child and I were very healthy with NO pitocin. I wouldn’t allow pitocin near me. Never!

    With this birth coming up I fully intend to allow myself the 42 weeks before I will consider the foley. If the foley doesn’t work I would rather opt for a repeat c-section before I would even consider using pitocin.

  23. Tara says:

    great info… thank you!

  24. Jess says:

    This is copy/pasted directly from the article:
    “Risks of VBAC: Uterine rupture (0.6 percent), and failed VBAC leading to another cesarean section (VBAC is estimated to be between 60-80 percent successful depending on the birth setting).
    Risks of a Repeat Cesarean: Infection, increased blood loss, decreased bowel function, respiratory complications, longer hospital stay, longer recovery time, reactions to anesthesia, the risk of additional surgeries, adhesions, future infertility, increased risk for placenta problems in future pregnancies, complications to the baby, and maternal death.”
    Why no stats on how often maternal death, infection, etc occur? I am all for Vbacs as well, but as someone who has had 2 necessary C-sections (1st emergency, and then planned due to placenta previa) and looking at most likely having a third, I feel partial info like this is a bit biased and can be fear-inducing for someone who hasn’t gotten the all the facts yet.

  25. nicole says:

    Thank you for this, I gave birth to my son in January via vbac and it was the most amazing thing ever. My daughter was breeched and they gave me no choice but to have a csection and I was young so I didnt think to search for someone willing to let me try, since that is also possible. I hope more women see the choice they can make and start choosing vbacs before just jumping into another csection.

  26. Amanda says:

    Labored then c-section with my first because labor had stopped and she would not come through my pelvic bones. Second was a planned c-section, uneventful birth. Third was 6 weeks early and i didnt even realize i was in labor. Got to the hospital and i was 8cm dilated. There was no time to prep for a c-section so I birthed my son vaginally even after being told of my risk of rupture during the entire pregnancy. It was the most rewarding experience and i hope that all women at least get to try vba2c if given the opportunity. My doctor was confident that things would go well, and they did.

Leave a Reply

Your email address will not be published. Required fields are marked *.

Previous Post Next Post