VBAC Support and Information Thread, Part II

The original thread did not run out of space, however, the OP has not been on since Feb. and the general consensus was that we needed a refreshed one with people information and an updated OP.
All are welcome! Feel free to post. All of the women who are working for a vbac are very passionate about it, and MORE than willing to give you the facts!
Original:http://forum.baby-gaga.com/about668412.html




Many women are misinformed, or not informed at all, about VBAC. I want this to be a place to find the information you need to make the decision to have a VBAC, or not, an informed one.
*****VBAC support & informational thread is for any and every mom thats ever had a c-section and has either had, is thinking about, or plans to have a Vaginal Birth After a C-section. ******
Here are the quick FACTS about VBAC. The refrences are in the link provided.


Quick Facts


After a cesarean, most women have two choices for future births: a vaginal birth after cesarean (VBAC) or a repeat cesarean section (RCS). There is a lot of misinformation about these two options. Let’s review some quick facts.
Per the American College of Obstetricians and Gynecologists (ACOG, 2010), VBAC is a “safe and appropriate choice for most women” with one prior cesarean and for “some women” with two prior cesareans. Being pregnant with twins, going over 40 weeks, having an unknown or low vertical scar, or suspecting a “big baby” should not prevent a woman from planning a VBAC (ACOG, 2010).
Research on uterine scar thickness (Kamel, 2009) and single vs. dual layer suturing (Humphries, 2004) are on-going as the studies completed thus far are not strong enough to provide conclusive support for specific actions.
VBAC is successful 75% of the time (Coassolo, 2005; Huang, 2002; Landon, 2004; Landon, 2006; Macones, 2005). Successful VBACs have lower complication rates than planned repeat cesareans which have lower complication rates than “failed” VBACs (Landon, 2004), otherwise known as cesarean birth after cesarean or CBAC.
Uterine rupture is the major concern in terms of VBAC and while it can be catastrophic, it is rare (National Institutes of Health, 2010).
Permitting labor to begin naturally after one prior low transverse (“bikini cut”) cesarean carries a 0.4% risk of rupture which can increase upon labor augmentation or induction (Landon, 2004). These rates are similar to other serious obstetrical emergencies such as placental abruption, cord prolapsed, and post partum hemorrhage.
Cesarean risks, including placenta accreta, hysterectomy, blood transfusion, and ICU admission, increase with each surgery (Silver, 2006); whereas after a successful VBAC, the future risk of uterine rupture, uterine dehiscence, and other labor related complications significantly decrease (Mercer, 200 .
With each option, the risk of maternal death is very low: 0.02% VBAC vs. 0.04% RCS (Landon, 2004). Additionally, the risk of infant death or brain damage during a VBAC is 0.05% which is “quantitatively small but greater than that associated with elective repeat cesarean delivery” (Landon, 2004).
45% of women are interested in the option of VBAC (Declercq, 2006), yet 92% have a RCS (Martin, 2009). Some women chose their RCS or it was medically necessary. Others felt like they didn’t have much of a choice for numerous reasons including hospital VBAC bans (Kamel, 2010); unsupportive health care providers, friends, and family (Kamel, 2009b & 2010b); or the misrepresentation of VBAC risks (Kamel, 2009b & 2010b).
Our repeat cesarean rate feeds our rising total cesarean rate, currently at 32% (Menacker, 2010). The World Health Organization (WHO, 2009) warns against total cesarean rates higher than 15% and indicates that at least half of American cesareans could be unnecessary. Declercq (2009) links our high cesarean rate with our high maternal mortality rate relative to other developed countries.
In all 50 states, hospital and doctor attended VBACs are legal and in some states it is legal for a midwife to attend an OOH (out-of-hospital) VBAC (Kamel, 2009c). However, of the women interested in VBAC, 57% are unable to find a supportive care provider or hospital (Declercq, 2006). This is due primarily to the 1999 ACOG recommendation that a doctor be “immediately available” to perform a cesarean, yet they provided no clear definition or standard for where the obstetrician and/or anesthesiologist should be or what they could be doing.
As a result, hospitals developed their own definitions producing differing VBAC protocols and requirements. The most severe variety was the institution of VBAC bans in one-third of all American hospitals (ICAN, 2009), disproportionally affecting women living in rural areas. As the new ACOG (2010) guidelines retracted this problematic proposal, hopefully VBAC will become a viable option to the many women who desire it (Kamel, 2010c).
http://vbacfacts.com/quick-facts/



Our VBAC Mommies:
SaraLiz VBAC Successful on September 7th, 2008!!!!!
Jacksonsmom VBAC Successful on July 28th, 2009!!!!!
Precious' MilkMaid *DMFVBAC successful on August 25th, 2009!!!!!
Tracy-VBAC PSM VBAC successful on October 3rd, 2009!!!!!
lilyinlove78*EOM* VBAC successful on November 5th, 2009!!!!!
Breanna(I CAN!) (Yours Truly)VBAC successful on December 25th, 2009!!!!! Labor and Birth Story: http://forum.baby-gaga.com/about930882.html
LoveMyTwoGirls(IDID-VBAC) VBAC successful on December 31st, 2009!!!!!
Romin & Ameliah's mommy VBAC successful on January 11th, 2010!!!!!
The Momma to *L*P*S* VBAC successful on January 23rd, 2010!!!!! Labor Story Here:http://forum.baby-gaga.com/about668412-146.html
A ♥s E.T. VBAC Successful on March 27th, 2010!
Maddox and Paxton's Mommy VBAC Successful on May 9th, 2010! Labor/Biirth Story:http://forum.baby-gaga.com/about1142078.html
VBACgrad.Mama.x2 VBAC Successful on June 3rd, 2010! Labor Story: http://forum.baby-gaga.com/about1204083.html
Falysha VBAC Grad VBAC Successful on June 13th, 2010! Labor Story: http://forum.baby-gaga.com/about1208410.html
Christian Chick ♥ VBAMC SUCCESSFUL!
Babybaker Successful VBA2C on September 15, 2010
Birth Story: http://forum.baby-gaga.com/about1379293.html
**Sheri HBAC Graduate** successful HBAC one on Dec 4th!
Vbac Graduate! VBAC successful... date to follow.
Mary VBAC SUCCESSFUL on May 2nd, 2011!

Pregnant and trying for a VBAC....
Sarah Trying for a VBAC and due May 7th!
http://members.baby-gaga.com/myprofile.php due May 21st! VBA2C hopeful.
Mercedes due June 12th and VBAC hopeful!
Jennifer Due June 17th. Vbac after breech c section.
Kay due July 1st and VBAC hopeful!
Arleen due July 6th.
Blessed with five due October 1st. VBA3C at a birthing center hopeful!
BOOBS! Due October 29th and VBAC hopeful!



Hoping for a VBAC in the future....
Raechals Mommy(: VBAC hopeful in the future
♥Kate{HBC}♥ VBAC hopeful in the future
Ms. Tesi VBAC hopeful in the future
Just Us Girls♥EBFBVBAC hopeful in the future
**Tiffer** VBAC hopeful in the future
Chloe's *PSMama =) VBAC hopeful in the future
Anthony's Mama* VBAC hopeful in the future
Maranda {JMM} VBAC hopeful in the future
Sabrina ♥ Sophie VBAC hopeful in the future
Lovin' Taylor Anne VBAC hopeful in the future
Brynley's Mommy! VBAC hopeful in the future
Coconut_CutieVBAC hopeful in the future
Mama Bee{VBAC HOPEFUL} VBAC Hopeful in the future
♥Sofia's Mommy VBAC Hopeful in the future
BoogsMommyEBFT VBAC Hopeful in the future
Jacks mommy {ERF} ( becca) - future vbac hopeful
dnmwantababy~Melissa VBAC hopeful after twins in the future
AllboutthemVBAC hopeful after twins in the future
♥Melis♥ VBA2C hopeful in the future
Boob Tick's Mom ebfb.HBAC hopeful in the future
tantric_lemons☮ebfbHBAC hopeful in the future
JenVBAC hopeful in the future



______________________________________________________

THE FOLLOWING INFORMATION IS TO CONSIDER WHEN DECIDING TO HAVE A VBAC
http://www.ican-online.org


There is a myth surrounding VBACs in the United States. That they are dangerous and life threatening. This is simply not true. Yet more and more women seeking a vaginal birth after a cesarean are left having no other option other then to have another c-section. Either their doctor is not supportive, or they find their local hospital has a de facto, or even written, ban on VBAC. This is discouraging to pregnant mothers searching for a natural birth experience after a previous c-section.

Hospitals take on VBAC
Since 2004 the number of hospitals refusing, or not supporting, VBAC has tripled. ICAN released a survey done in January 09 that surveyed 2,850 hospitals on their VBAC policies. 821 hospitals stated there was a "ban" on doing VBAC at their hospital, in addition to 612 saying that they had a "de facto ban" on VBACs. ( de facto ban is simple that they have no record of any doctors working through their hospital that support VBAC but the hospital its self has no official opinion on the matter) ICAN estimates that less then 10% of the surveyed hospitals were VBAC supporting. These "bans" are making it nearly impossible for expecting mother wanting VBAC to have the birth they want, or even need.
( The above was taken from an article in the May/June 2009 issue of Mothering magazine.)

So why the "ban"?
The fear that hospitals and doctors have is that the stress of labor and contractions may cause your uterine wall to rupture at the point where you had your previous c-section. BUT what doctors don't tell you is that this complication is very rare and can occur even in a women that has had no previous c-sections.

-According to a 10 year (1988-1997) population-based study there were 39 ruptures out of the 114,933 births reviewed. Out of those 114,933 births 11,585 had had a c-section previously to that birth (10%) and 37 of the reported ruptures were of those that had had a previous c-section (11,585). There was one reported neonatal death from an apparent uterine rupture but were NO reported maternal deaths.
( the above was taken from http://ican-online.org/vbac/uterine-rupture-a-10-year-population-based-study-uterine-rupture)

Reported Complications of Labor and Delivery in US for year 2000 (Rate per 1000 live births)
*Umbilical Cord Prolapse-----1.9
*Fetal Distress -----39.2
*Abruptio Placenta -----5.5
( Source: CDC: NCHS: Births: Final Data for 2000 )
www.cdc.gov/nchs/data/nvsr/nvsr50/nvsr50_05.pdf
*Uterine rupture rate per 100 women laboring for a VBAC, based on worldwide systematic reviews (0.09 to 0.8 %)-----0.9-8.0
( Source: Enkin et all 2000. A Guide to Effective Care in Pregnancy and Childbirth )
(chart taken from http://vbac.com/uterine.html )

National Institute of Health
http://consensus.nih.gov/2010/images/vbac/vbac_statement.pdf

HOWEVER, this thread is not going to be all one sided.

While there is evidence to support that VBAC is not only safe but should be encouraged there is also evidence to suggest that its too risky on the mother and child.

-There was a study that analyzing the records of 20,095 women who had their first child delivered by cesarean section and who delivered a second child either by cesarean or following labor. These records were from 1987 through 1996 and came from civilian hospitals in Washington State. The research fond that the rate of uterine rupture for repeat cesarean deliveries without labor for women having a previous C-section was 1.6 per 1,000 women. Uterine rupture was highest where prostaglandin, a naturally-occurring substance in the body administered to induce labor, was used for the second birth — 24.5 per 1,000 women. For women whose labor was induced without prostaglandin, the rate was 7.7 per 1,000 women. And for those with spontaneous onset of labor, the rate was 5.2 per 1,000 women. As these data indicate, uterine rupture is not that common, but it may have serious consequences that include hysterectomy, urologic injury, or need for a blood transfusion for the mother, and neurologic impairment in the infant.
( source:http://www.nih.gov/news/pr/jul2001/ninr-04.htm)
__________________________________________________________

******VBAMC ( Vaginal Birth After Multiple C-sections )
ACOG revised its guidelines a few years ago to restrict Vaginal Birth after
2 Cesareans (VBA2C) only to those who have had a prior vaginal birth. However, the Society of Obstetricians and Gynecologists of Canada (SOGC) does not restrict VBA2C only to those with a prior vaginal birth. The topic remains controversial.
In practice, with the backlash against VBAC of all types, many women are finding it difficult to find providers supportive of VBAMC at all. However, even though it may be difficult to find supportive providers, there are still women who are having VBACs after more than 1 cesarean.
( source: http://www.ican-online.org/vbac/vaginal-birth-after-multiple-cesareans)
__________________________________________________________

******HBAC ( Home Birth After Cesarean )

Comparing Home birth/HBAC to Hospital Birth
Comparison of Home birth & Hospital Birth
http://www.baby-gaga.com/outbound.php?post_id=16733893&url=http%3A%2F%2Fvbacfacts.com%2Fhbac.%2F

HBAC story
http://www.baby-gaga.com/outbound.php?post_id=16733893&url=http%3A%2F%2Fvbacfacts.com%2Fhbacbirth%2F

Home birth after Cesarean: The Myth and the Reality
http://www.baby-gaga.com/outbound.php?post_id=16733893&url=http%3A%2F%2Fwww.midwiferytoday.com%2Farticles%2FHomebirthAfterCesarean.asp
_______________________________________________________


**************************************************
You've decided to try for a VBAC, what should you know?
**************************************************

*Am I a good candidate?
General guide lines for a successful vaginal birth after a previous c-section:

1) You have already had a successful vaginal delivery. Women who have had at least one prior vaginal delivery have higher successful VBAC rates. A woman who has already had a successful VBAC is more likely to have a second successful VBAC than a woman whose vaginal delivery was followed by a C-section delivery. However, not having a previous vaginal delivery is not going to disqualify you.

2) Your chances for a successful VBAC are higher if the reason for your prior C-section is not likely to re-occur during the current pregnancy.
The chances for a successful VBAC for a woman who has had a vaginal delivery, but then had to have a C-section because of an infection, for example, will be equal to those of a woman who has never had a Cesarean. If the prior C-section was done because the baby presented in breech position, the chances of a successful vaginal delivery are somewhat lower, but a VBAC is still a possibility because the current baby may enter the birth canal in a more favorable position. If the C-section delivery was due to insufficient cervical dilation, or placenta previa (a condition where the placenta has attached itself to the lower uterine wall close to, or covering, the cervix), the VBAC success chance is lower.

3) You have less than two low transverse (horizontal) Cesarean deliveries. Note the scar on you belly does not indicate what kind of incision (or scar) is on your uterus. Refer to the medical reports of your previous C-section(s).

4) You are under 40. Women under 40 years old have an almost 3-fold higher chance for a successful VBAC than older women. In fact, women over 40 have a lower rate of successful vaginal delivery generally, whether VBAC or not.

5) You don't need medical labor induction. Labor inducing medication will increase the risk of uterine rupture tenfold, and pregnancy health care providers may decide to abandon the VBAC attempt if the mother needs oxytocin (Pitocin).
(source http://ezinearticles.com/?Can-You-Really-Have-a-Vaginal-Birth-After-Caesarian-(VBAC)?&id=1986402)

-VBAC checklist http://ican-online.org/vbac/vaginal-birth-after-cesarean-checklist


*Know your hospital's policies.
-Find out if your hospital is VBAC supportive? Look here to find a list of VBAC "ban" and VBAC "supporting" hospitals---http://ican-online.org/vbac-ban-info

-What to do if your hospital has a "ban" on VBAC.... http://www.ican-online.org/vbac/your-right-refuse-what-do-if-your-hospital-has-banned-vbac-q
If you hospital says they "don't support" VBAC.... http://www.ican-online.org/vbac/My-Hospital-Is-Currently-Not-Allowing-VBAC


*Know your rights.
-There is no law saying that VBACs are illegal!!
-You have the right to refuse any medical treatment, including a c-section.
-No hospital can turn you away if you are in active labor.
-No doctor can drop you as a patient within 30 days of your due date
http://www.ican-online.org/vbac/your-right-refuse-what-do-if-your-hospital-has-banned-vbac-q

-Vbac.com offers you a list of sites to learn more about your rights as a patient http://vbac.com/patientrights.html
-Visit www.BirthPolicy.org to learn more about the illegal and unethical status VBAC "bans".


( The majority of the information above was taken from www.vbac.com and www.ican-online.org Please feel free to explore them for further information. )

________________________________________________________________
THINGS TO CONSIDER ABOUT C-SECTIONS




What are some concerns about risks of c-section compared with vaginal birth?
When weighing planned VBAC versus planned c-section, the focus is often on potential problems with the uterine scar in labor or on problems associated with accumulating scars. But this results in an incomplete picture because it overlooks other risks that also differ between vaginal birth and cesarean section. Summarized here are some of the many extra risks associated with cesarean surgery as well as the few advantages.

Most of what we know about these risks comes from studies of cesarean in general, not planned c-section. Available research suggests that some of these risks may be lessened when the c-section is planned.

As you consider these, keep in mind that on average, 3 out of 4 women who labor after a c-section will give birth vaginally with care that encourages and supports VBAC (and fewer than 1 in 100 will experience the scar giving way). Even in cases where women scored 0 to 2 on a scale where 10 indicated greatest likelihood of vaginal birth, half gave birth vaginally.


-Physical problems for mothers: Compared with vaginal birth, cesarean section increases a woman's risk for a number of physical problems. These range from less common but potentially life-threatening problems, including hemorrhage (severe bleeding), blood clots, and bowel obstruction (due to scarring and adhesions from the surgery), to much more common problems such as longer-lasting and more severe pain and infection. Even after recovery from surgery, scarring and adhesion tissue increase risk for ongoing pelvic pain and for twisted bowel.

-Hospital stays: If a woman has a c-section, she is more likely to stay in the hospital longer and to be re-hospitalized.

-Emotional well-being: A woman who has a c-section may be at greater risk for poorer overall mental health and some emotional problems. She is also more likely to rate her birth experience poorer than a woman who has had a vaginal birth.

-Mother-baby relationship: A woman who has a c-section is more likely to have less early contact with her baby and initial negative feelings about her baby.

-Impact on babies: Babies born by c-section are more likely to:
be cut during the surgery (usually minor)
have breathing difficulties around the time of birth
experience asthma in childhood and in adulthood.
-Impact on any future babies: A cesarean section in this pregnancy increases risk
for babies in future pregnancies. Some research finds that babies who develop in a scarred uterus are more likely to:
be born too early (preterm)
weigh less than they should (low birth weight)
have a physical abnormality or injury to their brain or spinal cord
die before or shortly after the birth



What are some concerns about effects of accumulating uterine scars on future pregnancies and births?

The likelihood of the following problems grows as the number of previous cesareans (and c-section scars) grows:

-placenta previa: a woman whose uterus has a cesarean scar is more likely than a woman with an unscarred uterus to have a future placenta attach near or over the opening to her cervix; this increases her risk for serious bleeding, shock, blood transfusion, blood clots, planned or emergency delivery, emergency removal of her uterus (hysterectomy), placenta accreta (see next), and other complications.
Added likelihood for a woman with a previous cesarean: MODERATE for placenta previa in a future pregnancy after having one cesarean; HIGH for placenta previa in a future pregnancy after having more than one cesarean

-placenta accreta: a woman whose uterus has a cesarean scar is more likely than a woman with an unscarred uterus to have a future placenta grow through the uterine lining and into or through the muscle of the uterus; this increases her risk for uterine rupture (see below), serious bleeding, shock, blood transfusion, emergency surgery, emergency removal of her uterus (hysterectomy), and other complications.
Added likelihood for a woman with at least one previous cesarean: MODERATE for placenta accreta in a future pregnancy, with increasing risk as the number of previous cesareans grows

-rupture of the uterus: a woman whose uterus has a cesarean scar is more likely than a woman with an unscarred uterus to have the uterine wall give way in a future pregnancy or labor, especially at the site of the scar; this increases her risk for severe bleeding, shock, blood transfusion, blood clots, planned or emergency cesarean delivery, emergency removal of the uterus (hysterectomy), and other complications; whether a woman plans a repeat cesarean or a VBAC (vaginal birth after cesarean), she is at greater risk for a ruptured uterus than a woman with no previous cesarean.
Added likelihood for a woman with a previous cesarean: MODERATE for rupture of the uterus, with increasing risk for two or more cesareans

( source-http://childbirthconnection.org/article.asp?ck=10210)


****Any other sites or sources that you feel should be added to the above information are welcome. ****

VBAC Snaggables:

Could you put the ICAN link maybe after the original siggy? I know a lot of the info is from there but it'd be nice if it was accessible early on in the info since it's such a great resource IMO

ICAN site
ICAN Chapter Search
ICAN Forums

I'm on the list but I would like my due date and trying for a VBA2C put up versus just "in the future"

Quoting babybaker:“ Also I'm not sure if you have time r if these ladies still have the other thread on watch, but when you ... [snip!] ... watch, but when you get a chance I'd go through the due dates since I just noticed a couple of the links the moms miscarried  ”

Oh sad  the links are all clickable I'll go through them.

Wanted to share:
Triplet VBAC
http://doulamomma.wordpress.com/2010/01/08/triplet-vbac-in-ga-with-dr-tate/

This is a local story for me and definitely gives a lot of people hope that a VBAC is possible in many birth situations  

Quoting babybaker:“ Edited actually I got confused we may just need to move some of the hopefuls to the due date list  ”

I deleted one person out of trying for vbac and put two that were hopeful into trying.

I also PM'd mara to have this made into the sticky. If everyone is ok with that.

This was a great story shared in the other thread at one point.
This mom had 6 VBACs after 4 C-sections (10 births total)
http://treasuresfromashoebox.blogspot.com/2010/05/youve-had-how-many-cesareans.html

Quoting BreannaTITSORGTFO:“ I also PM'd mara to have this made into the sticky. If everyone is ok with that.”

Awesome! And have the other one taken off  

Quoting babybaker:“ I'll edit my first posts to have some random VBAC story links in a sec I think to stay on topic lol. ... [snip!] ... of the info is from there but it'd be nice if it was accessible early on in the info since it's such a great resource IMO  ”

Yes! Should I put links to peoples birth stories after their success if they'd like?
:cowers in my bigheaded need to share mine:

Released in March 2010
by the National Institute of Health
http://consensus.nih.gov/2010/images/vbac/vbac_statement.pdf

Quoting BreannaTITSORGTFO:“ Yes! Should I put links to peoples birth stories after their success if they'd like? :cowers in my bigheaded need to share mine:”

I'd love that.  

Can you update my name?

Quoting Sushi&Sy{VBAC hopeful}:“ Can you update my name?”

done!

Quoting BreannaTITSORGTFO:“ done!”

thanks!