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