Although she would be "devastated" if she would not deliver via VBAC
, she was still willing to go through another C-section because her baby's safety is her priority.
Votava said one of the greatest concerns during VBAC
births is a uterine rupture, in which the uterus breaks open at the old C-section scar.
In 2007, Grobman12 developed a prediction nomogram for the success of VBAC
based on factors available at the first prenatal check-up: Maternal age, BMI, ethnic group, previous vaginal delivery, successful vaginal delivery after C-section (the occurrence of a VBAC
), and recurrence of the indication of primary cesarean section, all of which had an adequate predictive value.
We then condition on prior Cesarean and estimate equation (1) for VBACs
. Note that the number of observations (both patient level and physician level) in the primary Cesarean models is different from the VBAC
models as the likelihood of a VBAC
is conditional on having had a prior birth, where that prior birth was delivered via Cesarean.
Obstetricians concerned about medical litigation in VBAC
due to severe PPH and neonatal asphyxia due to the rupture of the uterus.
For women who have had a single previous cesarean section, the best mode of delivery in a later pregnancy is controversial, as there are risks and benefits to attempting a VBAC
or having an elective repeat cesarean section.
Women with two prior low-transverse cesareans also are potential candidates for TOLAC, depending on other predictors of successful VBAC
. Factors that reduce the chances of a successful TOLAC include advanced maternal age, high body mass index, high birth weight, gestational age of more than 40 weeks at delivery, and preeclampsia at the time of delivery, according to the practice bulletin.
Landon et al., "The change in the VBAC
Rate: an epidemiologic analysis," Paediatric and Perinatal Epidemiology, vol.
Among 206 cases of pregnancy with previous one scar only, 13.5% were delivered by vaginal route (VBAC
) whether unassisted (20) or assisted (8) by forceps (1) or vacuum (7) and 86.3% were delivered by caesarean section whether emergency (60.1%) or elective (26.2%) [Table 3].
KEY WORDS: Vaginal birth after cesarean (VBAC
), Continuing midwifery care, Standard maternity care.
Even though many studies showing success rate of VBAC
higher (around 92%),  maternal morbidities associated complications of trial of labor are life threatening, and we conclude ERCS is safer when compared with VBAC
in view of maternal outcome.
I was fortunate, with Jack, that I was able to find a practice committed to vaginal birth after cesarean (VBAC
) and an experienced doula willing to help me with the labor, most of which I had hoped to do at home.