Why would someone want to attempt a vaginal birth after cesarean?
Many women who experienced a cesarean would still like to attempt a vaginal birth after cesarean with subsequent deliveries. They may desire this because they felt cheated from experiencing a vaginal birth, because they feel like a second surgery would be even more dangerous, or because they are less fearful of birth this time around. For whatever reason, many women have an interest in VBACs as evidenced by the many support groups available to those individuals.
What are the benefits?
- prevention of intensive abdominal surgery
- reduction of risk of infections
- lower risk of respiratory problems
What are the risks?
- uterine rupture
- uterine infection
- pelvic floor problems
What qualifies a birthing individual for TOLAC?
In regard to TOLAC (trial of labor after cesarean), ACOG recommends that women in whom the balance of risks and the chances of successful VBAC are acceptable to the patient and the physician are good candidates for planned TOLAC.
In other words, the benefits and risks, along with previous medical history all need to be considered prior to making a final decision about attempting a vaginal birth after cesarean.
Decisions about TOLAC should take into account the possibility of future pregnancies, because delivery decisions made in the first pregnancy after a cesarean delivery typically affect plans in subsequent pregnancies. Because of the risks associated with TOLAC, it should be attempted in facilities with staff immediately available to provide emergency care.
Many local hospitals have a level 3 or higher NICU and most have full-time anesthesiologists and surgeons on staff should something go awry. We are also blessed with one of the top three hospitals in the whole of the United States.