A vaginal birth after a cesarean section (VBAC) is an attempt by the medical community to allow women who have had a prior cesarean section to undergo a trial of labor because studies have shown that 60% to 80% of women who have had one prior c-section can successfully deliver a baby vaginally for their second or subsequent pregnancies. The problem with VBACs is the one percent of the time when a uterus ruptures, the results can be catastrophic for the child if the VBAC is undertaken in a hospital that is not equipped to be able to deliver the baby literally within 5 to 10 minutes of the rupture, which is generally seen as a drop or severe drop in the fetal heart rate on the fetal heart rate monitor.
In the 1990's when VBACs were encouraged, many hospitals which were not able to have physicians in the hospital for both anesthesia and obstetrics were doing VBACs and were unable to deliver the baby in less than 25 or 30 minutes from the time there was a problem and those baby's invariably ended up with severe brain damage or died. So the new guidelines while they talk about the advantages of VBAC, it's important that they be performed only in hospitals that are able to deliver babies quickly, including having 24 hour in house anesthesia and 24 hour in house obstetricians. Academic medical centers or facilities that do a large number of deliveries have that capability and can successfully do VBAC, but smaller hospitals should not be doing them.
Visit VBAC information video for more information.
C-section information: When doctors believe that a fetus may be harmed by allowing a vaginal birth to proceed, must consider a caesarean section or C-section. A C-section is a surgical procedure where incisions are made through the mother's abdomen and uterus to deliver a baby.
Reasons doctor's may perform a C-section include:
- The baby is too large for a vaginal delivery
- There is an abnormal heart rate in the fetus
- Fetal distress
- The mother has HIV or genital herpes
- Breech position
- Uterine rupture
