Vaginal Birth after cesarean is a safe and viable option for the majority of women who have previously had a baby born by cesarean surgery.
Your chances of having a VBAC depend upon a variety of factors, including, but not limited to:
Your motivation; Your health and nutritional status; your care provider; Your place of birth; How long you labor at home; and your support system. Some factors that may increase the odds in your favor include using a Midwife, and a professional Doula. Rochester Birth Network can supply you with lists of local midwives and doulas. Childbirth classes that not only thoroughly educate you and stress nutrition and how to stay healthy and low risk will help as well. A list of Independent Childbirth educators can also be obtained from Rochester Birth Network.
To maximize you chances of having a VBAC:
1) Educate yourself!
2) Stay well nourished and well hydrated during pregnancy and labor.
3) Spend your pregnancy loving your uterus and baby
4) Pick a care provider who has a VBAC rate of 70% or more
5) Avoid induction –they increase the risk of uterine rupture
6) Resist epidurals –they can reduce your chances of a successful VBAC by masking problems and interfering with labor
Additional suggestions from experienced Moms, Doulas, and Childbirth Educators include:
7) Hire a professional Labor assistant
8) Stay at home in early labor as long as possible. Don’t pay attention too soon. Pay attention when you have to. Learn and note the emotional signposts of labor.
9) Rest/sleep as much as possible in early labor, and stay mobile during active labor.
10) Work with a counselor/ICAN Representative/Doula/Childbirth Educator to identify where, and why things went wrong in your previous labors, and draw up a prevention plan.
11) Seek professional counseling if previous life trauma may have interfered with your belief in your body’s ability to birth normally. (See the RABN Post Partum Care Providers list for names of experienced professionals.)
Local Sources for information on VAGINAL BIRTH AFTER CESAREAN:
ICAN – International Cesarean Awareness Network – Unplanned cesarean? Planning a VBAC? Monthly meetings, a lending library, and woman-to-woman support for those dealing with their cesarean experience. Contact Kim Guck 585-729-2278 for more info, or the Rochester chapter of ICAN , or the National group www.ican-online.org ,
La Leche League – call lifeline 585-275-5151 for a referral to the nearest group, or for a brochure. www.lalecheleague.org
Birthlove website – www.birthlove.com
Gentle Birth choices website – http://www.gentlebirth.org/search.html
Silent Knife – Wainer-Cohen & Estner Open Season – Nancy Wainer
The VBAC Companion – Diana Korte Ina May’s Guide to Childbirth – Ina May Gaskin
Birth After Cesarean: The Medical Facts – Dr. Bruce Flamm
The Thinking Woman’s guide to Better Birth – Henci Goer
“Elective Cesarean Sections Riskier than Vaginal Birth for Babies and Mothers
“Recently, a few physicians have claimed that elective primary cesareans and elective repeat cesareans are safer for babies, and even for mothers, than vaginal birth. While selective use of the medical literature might seem to back up this claim, a review of the studies, which consider short- and long-term risks of cesareans, does not. Elective cesareans put babies and mothers at risk, use valuable and limited healthcare resources, have negative psychological and financial consequences for families, and substantially increase serious risks in subsequent pregnancies. “ (From the International cesarean awareness Network website www.ican-online.org)
Induction of Labor & Uterine rupture–
Fear of uterine rupture has caused many physicians to recommend repeat cesareans. Research clearly shows that the increase in the rate of uterine rupture is directly related to an increase in the use of induction of labor. Induction of labor is contraindicated for VBAC women. (Wagner, 2003)
In spite of recent changes in opinions of care providers about VBAC the facts have not changed: as long as a woman is not induced, her chances of uterine rupture remain 0.5% in women with transverse lower uterine incisions (Gaskin, 2003).
Midwife Ina May Gaskin does not recommend an Out-of-Hospital VBAC for the following women:
– Women whose placenta overlies a previous uterine scar
– Women who have had 3 or more previous c-sections (if they have not already had a VBAC)
– Women who had a previous classical incision (if they have not already had a VBAC)
Cesarean & VBAC Statistics as published 2009:
If you go here: http://hospitals.nyhealth.gov/index.php Then click county>facility>services tab>”switch to maternity care services” you’ll see that facility’s rates in comparison to the rest of the state in a chart below.
What I did find as far as a statewide number was this: http://www.health.state.ny.us/nysdoh/vital_statistics/2007/table14.htm This is statewide data also from 2007 showing a 33.7% statewide cesarean rate. It also shows a 35.4% cesarean rate & 9.1% VBAC rate for Upstate & a 31.8% cesarean rate & 11.7% cesarean rate for NYC.
U.S. Rates- Total Cesarean Rate 32.9% as of 2009.
New York State- Average Cesarean Rate of 39.4% (Prim. and Repeat)
Average VBAC rate of 10%
Upstate New York (Minus NYC)-Cesarean rate of 37.20%
Upstate NY VBAC Rate of ___________
Rates of Cesarean Sections, Rochester NY (as of 2012):
NY State: 34.1%
Highland – 27.6%
Strong – 36.5%
Unity – 33.3%
VBAC Rates for Rochester area hospitals (As of 2009)
Rochester General: 1.2%
Stats on Cesareans Overall (2009)
Cayuga Medical Center (Ithaca)- 33.6%
Community General (Syracuse)- 25.7%
Crouse (Syracuse)- 34.5%
Highland (Rochester)- 27.2%
Lakeside (Rochester)- 28.8%
Rochester General- 34%
Schuyler (Montour Falls)- 36%
St. Joe’s (Syracuse)- 36.2%
Strong (Rochester)- 37.1%
Unity (Rochester)- 31%
I’d like to point out that the World Health Organization states
that cesarean rates above 10% for regular hospitals & above 15% for
high risk hospitals are unnecessary & pose avoidable risk to moms,
babies, & moms’ future children- meaning that the farther you go past
those numbers, the more damage you are doing. I’d also like to point
out that homebirths attended by certified midwives have a less than
5% cesarean rate with similar/better outcomes than hospital births
with obviously far less intervention & more evidence-based
Normal, natural birth isn’t just about ‘experience’- it’s about
safety. It’s what’s safest for mom & baby.
If a hospital has an overall cesarean rate of 25%, 35%, 45%, 55+%,
what are the chances of actually achieving a VBAC there. . . which of
course depends a lot on whether or not you’ll be ‘allowed’ to try or not.
There are many hospitals here in upstate New York & all over the state &
country that deny women their right to full informed consent & refusal by
outright banning VBACs, essentially forcing women into repeat surgery.
You can view ICAN’s VBAC Policy Database here: http://www.ican-
online.org/vbac-ban-info. It is still in the works & being organized,
so thanks for your patience while we continue to work on it. There’s
a useful feature where you can add your own comments to a facility as
well. Thanks for your interest & support. Wishing you all happy,
healthy, safe birthing for your families & the ones you care about.”
ICAN of Syracuse Co-Leader
More information on Birth Statistics can be found here: http://www.cdc.gov/nchs/fastats/delivery.htm
HBAC (Home Birth After Cesarean)
There is a 2014 study out on Vaginal Birth After Cesarean in German out of hospital settings (including HBAC). Here is the link: http://healthybirth.net/wp-content/uploads/2014/12/HBAC-Birth-2014.pdf
And in 2015 Cox published a study on HBAC in the US in the Birth Journal: Cox, K. J., Bovbjerg, M. L., Cheyney, M., & Leeman, L. M. (2015). Planned Home VBAC in the United States, 2004-2009: Outcomes, Maternity Care Practices, and Implications for Shared Decision Making. Birth.