Vaginal Birth After Cesarean
While OB-GYN choices are slim, VBACs are still an option for women who choose to seek out information.
After her son was delivered by cesarean section, Shelly Collins was told she’d have to deliver all of her babies that way; a vaginal birth was no longer an option. Nine months after Wilder’s birth, Shelly became pregnant again, and she spent the first half of her pregnancy under the assumption that she’d eventually have another surgery. Until she began to do some research.
“It wasn’t until the third trimester (that I thought about having a vaginal birth instead),” Collins said. “The closer I got, reality started to set in. I was scared to have another C-section because of how bad it was the first time.”
With the birth of Wilder, Collins had an epidural and spent 30 minutes pushing before her doctor suggested a C-section. The nurse on duty thought she should keep pushing, and the difference of opinion was unnerving, Collins said.
The anesthesiologist had some difficulty administering her epidural, and by the time she was on the operating table, it had worn off enough for Collins to feel much of what was happening to her.
“(During my second pregnancy) I had done a lot more reading about natural childbirth than I had the first time around,” Collins said. “I would have thought about it sooner, but my new doctor told me I had to have a C-section. For most of my pregnancy, I sort of assumed that’s what my only option was. I started researching VBACs (vaginal births after cesarean) maybe because of fear.”
In her research, Collins found that VBACs aren’t impossible, but they are rare in Oklahoma. She called one of only a handful of doctors in the city — and state — who perform them.
Although VBACs are considered high-risk deliveries, the risks associated with them — primarily, a uterine scar rupture — happen in only about 1 percent of deliveries.
The reason they’re rarely performed in Oklahoma isn’t because of the nature of the delivery but because Oklahoma’s primary malpractice insurance provider, the Physicians Liability Insurance Corp., stopped covering VBACs in 2005, citing an excess of claims. About half of PLICO’s losses in 2003 were paid on claims in which failure to perform a timely cesarean was alleged, according to the company.
Physicians who want to provide VBACs can do so through other insurance providers, but few opt to perform them due to the extra strain VBACs impose on doctors.
Although the risk of uterine rupture is extremely low, if a rupture occurs, it can be deadly to the mother and baby.
All this talk about VBAC's is
All this talk about VBAC's is disturbing to me. Each article I read seems to be focused on how the mom's feel some sort of injustice was done to them because they had to have a cesarean section. I absolutely agree, major abdominal surgery is not an easy recovery, but wasn't it worth it to be handed a healthy baby? Would you have understood why you had to have a cesarean if you were handed an injured baby? The thing is, because you experienced the appropriate interventions at the appropriate time, you now have a healthy child. Rather than criticize the medical team, appreciate the committment they had that you experienced an optimal outcome. The delivery may not have played out as you fantasized, but your baby is safe and healthy. Surely you did not get pregnant merely to experience a vaginal delivery. As a mom myself, I would do anything to protect my children. If that meant I had to undergo surgery then that is what has to happen. The many sacrifices we make for our children as mothers begins the moment we find out we are pregnant.
On the other hand, if you feel like you recieved negligent care etc. that is a completely different topic. No one can force anyone to undergo a procedure and yes it is your body, however, there is another human being involved as well, your unborn baby. The medical team has an obligation to protect that human life from harm. By refusing to let the team intervene so they can perform life saving interventions for your baby is absurd. Would you keep them from your 3 year old who has stopped breathing and needed CPR? I doubt it.
No, cesarean sections do not bring in the $$$ for a facility and yes, women have been having babies for thousands of years, that is an obvious fact. How many women and babies died in childbirth over all those years? Yes, women were created to have babies, and we do, it is natural. We are all also created with hearts that are meant to pump oxygenated blood throughout our bodies, it is natural as well. If you or your loved one experienced a heart attack, I believe you would be grateful for the advances that have been made in medicine. Obstetrics is the same.
It is unfortunate that insurance companies have created such an obstacle for physicians to perform VBAC's. These are a higher risk delivery but they can be done in the right setting so that both mom and baby are kept safe. I believe every patient should be informed and know the facts, so research as much as you want, just do it right. Do not google or wikepedia, instead research databases.
ICAN of Tulsa
If you would like more information about VBACs, or for support and help in obtaining a VBAC, please contact the local Tulsa chapter of ICAN (International Cesarean Awareness Network) at icanoftulsa@yahoo.com.
Co-Leader, ICAN of Tulsa
Absolutely!
I was pressured into (1) induction and (2) subsequent C/S for failure to progress after about 12 hours of labor. Baby was healthy and not in trouble, and in the midst of labor I didn't have my wits about me to refuse the procedure. My OB was heavy on intervention and I didn't realize it until I was too far along in my pregnancy to change docs...and believe me, I tried. Those are decisions in the past that I can't change, but my husband and I have decided to be sure that this pregnancy and delivery (due in May) goes the way we want it (within the bounds of safety of course).
I called every OB on our insurance, and found about 3 regular OBs that allow VBAC, and at least one high risk doc. I am very excited about the opportunity to have a 'regular' delivery. We considered homebirth, but in our situation (of never having delivered vaginally) we are going with the hospital option this time.
I think it's a crime that women are told that they have no choice and that repeat section is 'safer' than VBAC. Cesarean section is a MAJOR surgery, and recovery is awful with a newborn to take care of...especially if you're breastfeeding. Women have been giving birth for thousands of years. Our bodies were made for this, and I believe it is best to allow the process to happen as naturally as possible. Praise God that the docs are there to step in when there's real danger, but I am so tired of unnecessary intervention for convenience sake. Oh, not to mention that the hospital and the doc make more $$ for a C/S. Also, you can refuse a C/S...it's your body and (it's my understanding that) without a court order you can not be forced to have one. That being said, if the baby is in real danger, absolutely do what's in their best interest.
I strongly encourage any other C/S mamas out there to do their research and make an informed decision that is best for them and their family. For me, it's an attempt at VBAC.
kudos
I think it's sad that insurance companies and many doctors look mostly at the bottom line when deciding whether or not to help women have a VBAC. Understandably many women need to have a cesarean but I think doctors often rush women into her first c-section when it's not really necessary and then make it extremely difficult to have a natural birth for subsequent children. Kudos to the doctors who are thinking more about helping mothers fulfill their wishes in a safe environment without concern for money. Having said that, I delivered two of my three kids with midwife-only care so I am a big fan of midwifery and the excellent care they provide for low-risk pregnancies.