VBAC Success Calculator

bundlesofjoy

I am 14 weeks and I was discussing the option of VBAC vs RCS with my new OB and she told me to hold on.  She googles a prediction calculator that estimates my VBAC chances are about 37%.  I was suprised by this and wasn't sure if this is something i should take seriously or if it is a way to scare women out of trying for a VBAC,  I hoped you ladies might have some info on this subject.  I'm still trying to decide for myself if I want one or if I want the RCS and I can't tell if my OB is pro VBAC yet.  Thoughts?

eco+ri

My success calculator stated 55.7%, and I am still going for it. I would say go for it, until something prevents you from doing so. I wouldn't solely rely of some interent calculator. Truth be told, RCS could potentially put you at just as great a risk. Cesarean recovery leaves you open to infection (which I have first hand experience with). I say go for it, get your VBAC on : ). 

nosoup4u

Why did you have a c/s the last time? Have you talked to her about what happened? Is the same doctor you were with during your last pregnancy? How many successful VBACs does she have per year?

A 37% chance of a successful vaginal birth is still better odds than a 100% chance of a c-section for some women. The overall success rate of VBAC is actually about 75% (but obviously varies with individuals).

It probably wouldn't hurt to interview other providers if you're certain you want a VBAC.

cchill01

It's a warning sign about your doctor for sure.  One of the problems with calculators is that they don't take into account the dedication of those attempting the VBAC.  I believe that if you really want a VBAC and your OB/midwife is really in support of your attempt, the success rate is much, much higher.   My chances of success were about 59% according to one of the calculators, but my midwife's success rate is around 95%.  So, there's something missing from the calculators.

But, to put this in perspective.  If I told you there was a 37% chance you would win the lottery, you'd buy a ticket.  So, even those odds don't seem so bad to me.

MAprincess

cchill01:

It's a warning sign about your doctor for sure.  One of the problems with calculators is that they don't take into account the dedication of those attempting the VBAC.  I believe that if you really want a VBAC and your OB/midwife is really in support of your attempt, the success rate is much, much higher.   My chances of success were about 59% according to one of the calculators, but my midwife's success rate is around 95%.  So, there's something missing from the calculators.

But, to put this in perspective.  If I told you there was a 37% chance you would win the lottery, you'd buy a ticket.  So, even those odds don't seem so bad to me.

This is a great way to put it.

I didn't use a calculator to determine my odds, but I had a large baby the first time and was almost 42 weeks when he was born so the OBs I interviewed didn't want to even have me attempt.  I VBACed at 41 weeks, induced, no problem.  Those calculators don't mean much. 

pepomntpat

I find the process of Googling something random on the Internet for a patient to be very unprofessional.  She should use her professional judgement based on your medical history to give you advice.  And if you are not satisfied with that advice then get a second opinion.  I like to use calculators for my own information, but the thought that my OB is relying on a calculator that she Googled would make me question the OB, not my VBAC chances.

cecilyandgautam

Took a quick look at the calculator and it seems to run a very basic estimate based on risk factors related to your age, weight, race/ethnicity, and reason for your prior c-section. I think this just basically acknowledges your chances of facing the same risk factors you did the first time - if hypertension, GD, previa etc were issues for you the first round, they may be again but what this doesn't take into account is that you can do things differently this time. If you gained too much weight or didn't exercise during your last pregnancy - you can fix that this time if you've got the resolve. 

Also, if you agreed to an unnecessary induction last time, you probably wouldn't be so easily convinced this time and that alone will really improve your chances of a vbac. For a 30% chance of success, I would try for a vbac and I would generally try to improve my chances throughout my pregnancy. Even for a 5% chance, I would try. 

pepomntpat

letranger:

I just googled one since I had never heard of it. Based on the questions I find it unreliable prediction. Bmi is flawed for example.

Yes. How do you calculate the BMI of a pregnant woman?  If i put in my pre pregnancy weight I get a 70% chance. If I put in the weight I will be if I gain what the doctor recommends it goes down to 60%.  So, I don't know... 

cecilyandgautam

!! Just saw this little disclaimer at the bottom: 

"It is designed for educational use and is based on a population of women who received care at the hospitals within the MFMU Network. "

So if you go with a home birth, this little predictor is not at all relevant.

Also, for those of you wondering whether to use your pre-pregnancy weight or end-pregnancy weight, I'm pretty sure you're supposed to use pre-pregnancy weight because my Drs & midwives all used my pre-preg BMI as a reference and I've never heard of a BMI chart for pregnant ladies.  

penguingrrl

I was given a maybe 20% chance of success from a VBAC friendly OB and I was successful, so I would say she was giving you the true odds but is willing to help you (unless she said other  things that would lead you to believe she's not truly VBAC supportive). The practice that delivered my VBAC baby had had 2 VBACs in the two weeks before my first visit, so I knew they were strongly supportive, but were being honest about my odds.

In the end I had high blood pressure and borderline pre-e and they were willing to induce then I pushed for 3 hours and they were willing to use forceps to assist instead of going for a C. So about as VBAC friendly as you can get!