VBAC or Repeat Cesarean?

Facts to consider when you need to choose between a VBAC and an elective repeat cesarean.

© Brenda Lane

Oct 4, 2006

If you are trying to make the tough decision between having a VBAC and trial of labor versus scheduling an elective cesarean, here are some helpful things to keep in mind:

1. Elective repeat cesareans carry multiple risks (including minor risks such as UTI's and major ones such as hemorrhage and hysterectomy) which overall may be more likely to occur than the same or other risks from having a VBAC.

2. VBAC does have a risk of uterine rupture of about 1% which might be lowered by going into spontaneous labor.

3. There are at least ten ways women can reduce their risk of having another cesarean.

4. Putting a positive spin on the stats - women with a previous cesarean and have a trial of labor have a 99% chance of not having a uterine rupture.

5. If you want a VBAC and find that your provider is not supportive, find one who is. Often providers with a very low intervention rate overall will tend to have a low cesarean rate and also be more supportive of VBAC. One study actually showed that one of the "windows" into the philosophy of the provider was to ask if they cut episiotomies. Those providers that cut episiotomies also tended to intervene medically with a higher level of other interventions. See Questions to Ask Your Provider.

6. If you decide to have an elective repeat cesarean, the risk of complications, primarily to the mother, grows after each cesarean. Do not make this decision in haste since it can affect how the rest of your children come into this world as well as how many children you should safely have.

7. Be sure to discuss all of your options for VBAC or repeat cesarean with your provider and entire birth team. New research is occurring every year so be sure you are up-to-date with fact-finding.

8. Many mothers-to-be find that reading, journaling, lots of discussion and prayer helps them to make the best decision for themselves and their own families.

9. Research tells us that women who have a trial of labor do not regret it.

10. Neither choice is pain-free. VBAC brings pain with labor and elective cesarean brings pain during your recovery and during the time when you need to be taking care of the baby.

11. Many women report that recovery after a VBAC is much easier. See this mother's story on our discussion forum.

12. If you are considering having a VBAC, be sure you make different choices this time especially with regard to inductions, epidural anesthesia, choosing a supportive birth team, including a doula and planning your birth. It will be very hard to make the same choices and NOT have the same outcome.

Are you planning a VBAC or elective repeat cesarean? Tell us more.

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