Natural Childbirth Tips From Midwives : VBAC

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VBAC refers to vaginal birth after cesarean, and this is becoming more common as the cesarean rate has risen. Learn about finding a provider who will attend this type of birth with help from a certified nurse-midwife in this free video on VBAC and pregnancy.

Part of the Video Series: Natural Childbirth: Tips From Midwives
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Video Transcript

I'm Michelle Collins, Certified Nurse-Midwife and Professor of Nursing at Vanderbilt University School of Nursing. Addressing the issue of vaginal birth after cesarean or VBAC. Vaginal birth after cesarean is becoming more common since the cesarean rate has gone up. However, if you are pregnant and have had a prior cesarean and interested in a vaginal, trying for a vaginal birth, you want to make sure that you have a provider who also will be attending a vaginal birth after cesarean. Because there are providers who do not do that. So that's the first thing is to establish that with the relationship with your provider. A risk associated with vaginal birth after cesarean is that there is about a one to two out of one thousand women who are into labor with prior cesarean section who may have a coming apart of the scar inside their uterus from the prior cesarean. That risk is higher if the woman has had what's called a classical incision in her uterus which is an incision that goes up and down in the uterus. The incision that most women have these days for cesarean goes across the uterus and that is the one that is far less likely to have a separation during labor or birth. There's also an increased risk of this occurring if Prostaglandins are used to induce the labor or induction of labor in general. Some risks of a repeat cesarean section however, and looking at the decision for vaginal birth versus repeat cesarean section can include damage to the bowel bladder, higher risk for a blood transfusion, hysterectomy and higher risk of admission of the baby to neonatal intensive care unit. The national success rate of women attempting a vaginal birth after cesarean is around 75%. So most women who've had a prior cesarean and then go on to try to have a vaginal birth are successful. Some contraindications to trying to have a vaginal birth are the vertical incision in the uterus. Also if you are going to give birth in a place where there is not the ability to perform a cesarean section in a very timely manner or if you've had two prior cesarean sections and no history of ever having had a vaginal birth, the American College of OBGYNE doesn't recommend that you participate in attempting to have a vaginal birth after cesarean. But it's an issue that you want to discuss with your midwife or your physician because many women who want to try are successful.

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