When Should I Consider A VBAC?

Thank you to Heartland Women's Group for sponsoring this post and providing excellent medical care for Wichita moms!

As an obstetrician and gynecologist, some of the most common questions I get center around the topics of Cesarean sections (C-sections) and vaginal birth after cesarean — VBAC for short. A woman who wants to attempt a vaginal birth after having a cesarean section will go through a Trial of Labor After Cesarean (TOLAC); if they deliver, we call it a VBAC.

Here are some of the most common questions about VBACs:

How likely is a VBAC to be successful?

The success rates range from 60 to 80 percent for any VBAC, generally speaking.

Those women who have had a prior vaginal delivery either before or after their C-section are considered the most favorable candidates.

What are some of the benefits of a VBAC?

If a woman does have a successful vaginal delivery, the recovery is much easier, and she’ll have a lower risk of complications seen with major abdominal surgery, such as infection, blood clots, adhesions or bladder injuries, to name a few. If you’re planning to have a large family, it’s especially important to consider a VBAC due to the risk of complications increasing incrementally with each C-section.

What are the risks involved with a TOLAC and when is it safe to attempt?

The most feared complication of a TOLAC is uterine rupture, which occurs 1 percent of the time. If a uterine rupture does happen, it is potentially devastating with increased blood loss and possible hysterectomy (to stop massive blood loss). Thankfully, these complications are quite rare and furthermore, when a TOLAC is attempted under the guidance of a skilled and experienced OB/GYN, recognition of the early signs of compromise allows interventions to ensure the safety of the mother and baby. A good candidate for a VBAC is someone who has a “known” low transverse uterine scar, and has had less than three prior C-sections (note: the scar that is visible on your skin is not a reliable indicator of the uterine incision).

If you wish to attempt a VBAC, it’s extremely important to see an OB/GYN who is fully capable of monitoring labor very closely, and in the rare circumstance of uterine rupture, has the skills and experience to perform timely, life-saving surgery to ensure the safety of you and your baby.

If you are interested in learning more about TOLAC and VBAC, reach out to your OB/GYN today or call Heartland Women’s Group at (316) 858-7100 or visit our website.

About Dr. Hershberger

Dr. Damen Hershberger is a Board Certified Diplomate of the American Board of Obstetrics and Gynecology, skilled and experienced in VBAC deliveries, and gynecologic surgery. Dr. Hershberger practices with the Heartland Women’s Group and is also a Clinical Instructor at the University of Kansas School of Medicine, Department of Obstetrics & Gynecology.
A certified robotic surgeon, he has lectured internationally on the subject of minimally invasive surgery. Dr. Hershberger and his wife are Wichita natives and have four children. Contact Heartland Women’s Group at (316) 858-7100 or visiting our website.

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