First off, they’re actually called TOLAC (Trial Of Labor After Cesarean). But, no one wants to be a Toe-lac. They’d rather be a VBAC (a VBAC would actually be a sucessful vaginal birth after cesarean section). There, feel educated?
This is always on a pendulum. I’m not sure how much of that pendulum is associated with the malpractice insurance, as that is where a lot of anything comes from in this business. When I first started (13 years ago), NO ONE VBAC’d, and then we went to where most OB’s were trying it, and now I feel like we’re swinging back the other way. Here’s my 5 thoughts on VBAC’s.
1. Ask your doctor their VBAC rate. Some just don’t do them. Ever. And that’s their choice. You have to realize that once a person (because doctors are PEOPLE) have a bad experience with something, they are unlikely to do it again. Labor and delivery can be a happy place, but VBAC gone wrong can make it a very sad place.
2. Your doctor, most likely, will have to be on the hospital campus if you are in labor as a VBAC. For our doctors, their offices are on our hospital campus, so that works well during the day. Basically, they need to be there within minutes if something happens.
3. The main concern with VBAC’ing is uterine rupture. That means, your uterus will start to pull apart a your old incision. Your uterus thins considerably during pregnancy (as it is stretched out). That is totally normal. You might have heard of people who have a “window” — that means the uterus is so thin, it goes translucent in areas and you can see the baby. I have also heard of windows on patients who haven’t had c-sections, so take that for what it’s worth.
4. You might want to consider an early epidural. A few of our anesthesiologists push hard to have an in-dwelling epidural catheter once you’re in labor. That way, if you have to have emergency surgery, you won’t need general anesthesia. General is no fun.
5. Go with what your doctor says. If your doctor has a few patients that they HAVE done VBAC’s on, consider their opinion. Why did your first one happen? Was it twins, or breech? In that case, you don’t have a tested pelvic vault. You might want to consider it. If you didn’t dilate or the baby didn’t descend, it is likely to not happen again. SO, ask your doctor (none of these things I have said here should take the place of asking your doctor — they know you and your health history). FIND. A DOCTOR. YOU. CAN TRUST. The end.Anyway, those are my thoughts about VBAC’s, (or TOLAC’s). I must say whenever I have one, I feel like a warrior who’s just won a pretty significant prize. I’m pro-vagina. 🙂 My friend Katelyn has a great post about successful VBAC — and she should know, she’s had 2 of them!
Hilary is a nurse who has worked in various medical fields for the past 17 years, however, none of the information on this blog, should be substituted for the care of a physician. The information provided on this blog is informational only and shouldn’t be taken as medical advice. If you have questions, please ask your doctor. If you think you have a medical or psychiatric emergency, please call 911. Also, please don’t delay contacting a physician due to something you have read on here. Pulling Curls doesn’t take responsibility for your health. That’s your job. We’re just a nice read.
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