Labor After You Have Had a Cesarean
More Success for VBAC When Childbirth Start on Its Own
Nov 1, 2009
If you have already had a cesarean, you have two choices with your next pregnancy. You can schedule a cesarean or wait for spontaneous labor and plan for a vaginal birth after cesarean (VBAC).
More often than not, mothers with a previous cesarean are encouraged to schedule another cesarean with their subsequent pregnancy. In fact, support for VBAC in some areas has dwindled to such a degree that it is not unheard of for providers or hospitals to refuse to work with a mother planning a VBAC.
The good news is that research on VBAC is continuing to show parents that odds are in their favor to have a successful VBAC. Not to mention that allowing nature to take its course by waiting for the mother's body to go into spontaneous labor , i.e. by going into labor on her own, may be one of the most effective ways to have a vaginal birth.
Statistics of Successful VBAC Increase When You Go Into Labor
An exciting new study looked at what happens to the VBAC success rate when mothers went into spontaneous labor versus being induced or using cervical ripening agents such as prostaglandins. Records were reviewed over a six year period with over 16,000 mothers in the UK participating in the study.
Roughly 1/3 of the mothers in the study went into labor spontaneously. About 27% had their membranes stripped in order to start labor and about 38% of the mothers had a cesarean when labor did not begin. (It may be interesting to discover how long care providers waited before doing a cesarean in this group since potentially waiting until 41 weeks or later before performing a cesarean might reduce this figure.)
The Majority of Mothers Had a VBAC When Labor Started on Its Own
In the two groups combined (who either had spontaneous labor or their membranes stripped), a whopping 67% of them were able to have a successful VBAC. This is an amazing statistic to note since many mothers are hearing today that their chance of having a successful vaginal birth after a previous cesarean is much lower.
Subsequent Rate of Cesarean is Low after Going Into Labor
Only 16% of the mothers with a previous cesarean who went into labor spontaneously with their next baby ended up with another cesarean. Based on this study's findings, a mother planning a VBAC can feel certain that if she goes into labor on her own, she has a significantly higher chance of having a vaginal birth than having another cesarean.
Study Showed No Reports of Uterine Rupture
Even more encouraging news regarding VBACs is that in the entire group of 16,000 participants in this study, there were no reported cases of uterine rupture. This risk is often one of the reasons mothers are hesitant to pursue a VBAC. Yet clearly this study confirms that the risk of uterine rupture is actually quite low.
Other Ways to Increase VBAC Success
In addition to going into labor on your own, don't forget to add several other items to your VBAC tool kit. There is a new test available which measures the thickness of your uterine scar. This can be reassuring to your care provider that your chances of uterine rupture are even lower. To increase your VBAC success, you can also benefit from staying active and walking during labor, hiring a birth doula and waiting until labor is well-established before getting an epidural.
References:
Oqbonmwan, SE "Review of vaginal birth after primary cesarean section without prostaglandin induction or syntocinon augmentation in labor" Journal of Maternal Fetal and Neonatal Medicine, July 2009.
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