risks with VBAC

zebrastripes

What are the risks of having a VBAC? I know there is risks with the c-section but I am trying to weigh out the pros of cons of choosing between a VBAC and just scheduling another c-section.

I was almost certain of wanting a VBAC until I found out my local hospital does not allow VBACs. The closest hospital in my area that offers a VBAC is 1 hour and 20 mins away. I had a hard time finding a doc that would even consider a VBAC. After knowing the hospital does not allow it whatsoever, it made me wonder how big are the risks and why would they not allow VBACs at all. Many say it's b/c the c-section costs alot more but legally a hospital could not say no to VBACs so they can collect more money. There has to be some medical reasoning against turning away VBACs. 

I have also been reading about it online and have came across the chance of the VBAC not be successful and having to proceed with a c-section anyway.

novilise

Maybe the hospital just doesn't have access for 24 hour emergencies. I know that sounds strange, but apparently some hospitals don't. You'd think with any birth, they should have that, because anything can potentially go wrong for anyone...just in case.

I've been researching a lot....so so much!...because I am debating another c-section or a VBAC, too. Basically, there is statistically a slightly higher risk for the baby with a VBAC, but with a RCS, there is a slightly more dangerous risk for the mother...and future pregnancies. 

But a lot of things can change your personal potential problems with a VBAC. 

Why did you need your first c-section? Some problems are not likely to reoccur. 

Many doctors won't induce you now for a VBAC because it can make it more dangerous for a uterine rupture, but I have heard that some doctors will carefully monitor some women successfully with some induction. 

holly321

I don't really know all the risks, but I believe there is always the risk of uterine rupture just from being pregnant after a c section.

zebrastripes

The hospital that told me they did not allow VBAC is the same hospital that performed the c-section at 3AM. So their reasoning for not doing VBACs must be for another reason other than not having 24 hour emergencies. That is an odd thought of a hospital not having a 24 hour emergency service but I do know a hospital that has no OB ward so I guess anything is possible. 

Well, I developed toxemia in the end of 36 weeks so I was admitted to the hospital. They waited for a few days (until I was 37 weeks) before they decided to begin inducing. The doc broke my water and then began inducing. After 24 hours, my DD began to get stressed so they had to perform an emergency c-section.

 

iris427

Hospitals may not do VBACs if they don't have an OB and an anesthesiologist in the hospital 24 hours a day.  Many smaller hospitals do not and they have to call people in for a c/s.  There's a lot of controversy over this being a reason not to do VBAC, because something can go wrong in any birth.  VBAC is really not that different from any other vaginal birth

They may also not do it because of litigation fears--this has nothing to do with medical safety.  So don't think that if a hospital bans VBAC it's because VBAC is dangerous.

The main risk of VBAC is the scar rupturing.  If you've had one prior low horizontal incision, the risk of this happening is somewhere around 0.7%.  If it does happen, it's a medical emergency and you need a c/s, but most ruptures have good outcomes.  There is a small increase in fetal deaths.

Other than that, a VBAC is no different from any other vaginal birth.  RCS also carries some serious risks like an increased risk of postpartum hemorrhage, emergency hysterectomy, infection, organ damage, placental problems in future pregnancies, and maternal death.  So it's not like VBAC is riskier than RCS.

Here is a link that gives you some numbers:

https://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/weighing-the-pros-and-cons/ 

MrsVictoriaB

iris427:

Hospitals may not do VBACs if they don't have an OB and an anesthesiologist in the hospital 24 hours a day.  Many smaller hospitals do not and they have to call people in for a c/s.  There's a lot of controversy over this being a reason not to do VBAC, because something can go wrong in any birth.  VBAC is really not that different from any other vaginal birth

They may also not do it because of litigation fears--this has nothing to do with medical safety.  So don't think that if a hospital bans VBAC it's because VBAC is dangerous.

The main risk of VBAC is the scar rupturing.  If you've had one prior low horizontal incision, the risk of this happening is somewhere around 0.7%.  If it does happen, it's a medical emergency and you need a c/s, but most ruptures have good outcomes.  There is a small increase in fetal deaths.

Other than that, a VBAC is no different from any other vaginal birth.  RCS also carries some serious risks like an increased risk of postpartum hemorrhage, emergency hysterectomy, infection, organ damage, placental problems in future pregnancies, and maternal death.  So it's not like VBAC is riskier than RCS.

Here is a link that gives you some numbers:

https://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/weighing-the-pros-and-cons/ 

I could never be aiming for a VBAC without your reassurance and awesome info. Everytime I get nervous about it, I read one of these posts and instantly feel more calm and relaxed about the risks!

Pixiestx

There was an article in the paper here a couple years ago and a hospital here in NJ, which wasn't a small place, had their spokesperson saying that they believed vbacs should be done in hospitals with higher level NICU's.  I forget which level they had and what level they thought was appropriate.

zebrastripes

Thanks for sharing the link.  This is such a hard decision for me and maybe all the info can help me with my decision.