Sometimes I'll be on social media thinking everyone knows what I'm talking about and then someone asks me, "But wait! What is VBAC?!" What is VBAC!?!? What is VBAC?! And then I realize... not everyone knows about the VBAC option. VBAC is an acronym that stands Vaginal Birth After Cesarean.
History of VBAC
For YEARS... DECADES... women were told, "once a cesarean, always a cesarean." The idea of being able to have a normal vaginal delivery after experiencing a c-section was believed to be of grave danger to both mom and baby.
According to ACOG (American College of Obstetricians and Gynecologists), in the 1970s researchers began to challenge the "once a cesarean, only a cesarean" practice. The data they've accumulated since has changed maternal medical care framing TOLAC (or trial of labor after cesarean) as a reasonable option for some situations.
In 1985, VBAC rates were around 5%, and by 1996 increased to an impressive 28% (for contrast, current VBAC rates are around 13%, with a World Health Organization goal of 18%). Simultaneously, the Cesarean Delivery Rate decreased from about 23% to about 20% during that time frame. Unfortunately, as TOLAC rates increased, healthcare providers began to notice a rise in cases of uterine rupture. As a result, VBAC rates plummeted and Cesarean rates skyrocketed again. By 2006 the VBAC rate had decreased to just 8.5% and the cesarean delivery rate had reached over 30%. On top of it, many hospitals instituted a VBAC Ban.
Around 2010 researches started realizing that maybe we were taking to strict of an approach to VBAC, and more data is needed to really understand the benefits and risks of VBAC, the benefits and risks of repeat cesarean, the risks of uterine rupture, and other nuances surrounding VBAC.
Since, it has been determined that perhaps it is not the RISKS of VBAC that has stopped providers from supporting the option, but rather, providers and facilities are highly impacted by concerns over liability when supporting vaginal birth after cesarean.
Is VBAC safe?
With the fear of uterine rupture, and some doctors and hospitals refusing to offer or support vaginal birth after cesarean, many women find themselves asking if VBAC is even a safe option. The truth is, YES, VBAC is safe.
Compared to planned repeat cesarean, a successful VBAC is associated with lower risks of complications for mom and baby including infection, hemorrhage, breathing concerns, breastfeeding challenges and more (you can read more about the benefits of VBAC here). Of course, with every decision comes risk. A trial of labor after cesarean (TOLAC) that ends in an emergency repeat cesarean is associated with higher risks than a planned repeat cesarean. That being said, most low risk women planning a VBAC with the right support team and provider should have a safe, successful VBAC.
Why do women choose VBAC?
As a VBAC mom, myself, and a birth doula, I've often heard people say things like, "Why would anyone even want a vaginal birth after a cesarean?" or "Isn't a scheduled c-section just easier?" Each woman is going to have her own goals and preferences in regards to birth, but for many women, the recovery from a surgical birth is not easier than the recovery from a vaginal birth, they have spiritual or emotional reasons for wanting a vaginal birth, they believe in giving birth as God intended, they feel cesareans are over-utilized, want large families and therefore do not want to take the risks that come with multiple cesareans, and those are just a few reasons why women choose VBAC.
"What can I do to improve my chances of a VBAC?"
When a mother decides she wants to pursue a VBAC, the next question is typically "What can I do to improve my chances of a successful VBAC". If you google this questions, I'll bet you'll get all kinds of good and bad advice. Social media groups can be a terrible place to go searching for answers to this question. You'll see so much hostility and debate. As a VBAC mom and doula who specializes in support vaginal birth after cesarean, I could give you a million tips on planning your VBAC, but most importantly, you need to have a truly supportive provider for your VBAC, you need to understand physiological birth, and you need to learn the Three Pillars of Confidence. The truth is, planning a VBAC isn't much different from planning any other vaginal birth, except it has a slightly higher risk of uterine rupture and is doused in stigmas and fear.
Resources for women planning a VBAC
If you are planning a VBAC or know someone planning a VBAC, and would like to learn more about overcoming the fears associated with Vaginal Birth After Cesarean, there are some amazing resources available for you that you can access right now!! You can subscribe to The VBAC Podcast and learn the truth about VBAC while hearing inspiring VBAC birth stories. You can also get instant access to the FREE Combating Fear During VBAC online birth mini-class right now! If you're ready to get to the meat and potatoes and learn ALLLLLL the things, you can join VBAC With Confidence Complete Birth Prep Program or send me an email about how we can work together one on one to help you cultivate a positive and peaceful VBAC experience. You'll understand why your c-section happened, process any concerns you have about your previous cesarean and how it will impact your next birth, any fears surrounding VBAC, practice self advocacy skills, and so much more!
Jaimie Zaki is a wife, mother of four, LPN, VBAC Birth Doula, IBCLC (International Board Certified Lactation Consultant), Author, and hostess of theVBACpodcast where she is dedicated to inspiring mothers to cultivate a positive and peaceful vaginal birth after cesarean birth experience. Jaimie has had one cesarean, one hospital VBAC with an epidural, and two unmedicated homebirth VBACs. Jaimie has been supporting women through hospital births, out of hospital births, and the breastfeeding journey since 2016 starting as a La Leche League Leader, eventually opening her Labor and Lactation support private practice. Connect with Jaimie here.