Being Pregnant
Repeat C-Section or Vaginal Birth After Cesarean?
With the new revaluation that repeat c-sections are driving up the cesarean section rates across the country, it brings up the age old question… Is VBAC (vaginal birth after cesarean) safe?
The answer to that question is YES! In healthy, low risk women with no complications it is the safest option after having a previous cesarean delivery.
Unfortunately because of the number of women having repeat c-sections, the true information and statistics surrounding vaginal birth after cesarean are being swept under the rug, and not given to patients by their providers.
Dr. Stuart Fischbein takes it on in this youtube video:
Some of the risk related statistics I find most helpful for making an informed decision about VBAC are:
1st Cesarean
Risk of Hysterectomy : 0.65% (1 in 154)
Risk of Blood Transfusion : 4.05% (1 in 25)
Risk of Placenta Accreta : 0.24% (1 in 417)
1st VBAC
Chance of Successful VBAC : 63.3% (2 in 3)
Risk of Uterine Rupture : 0.87% (1 in 115)
Risk of Hysterectomy : 0.23% (1 in 435)
Risk of Blood Transfusion : 1.89% (1 in 53)
2nd Cesarean
Risk of Hysterectomy : 0.42% (1 in 238)
Risk of Blood Transfusion : 1.53% (1 in 65)
Risk of Placenta Accreta : 0.31% (1 in 325)
Risk of Major Complications : 4.3% (1 in 23)
Risk of Dense Adhesion’s : 21.6% (1 in 5)
2nd VBAC
Chance of Successful VBAC : 87.6% (9 in 10)
Risk of Uterine Rupture : 0.45% (1 in 222)
Risk of Hysterectomy : 0.17% (1 in 588)
Risk of Blood Transfusion : 1.24% (1 in 81)
3rd Cesarean
Risk of Hysterectomy : 0.9% (1 in 111)
Risk of Blood Transfusion : 2.26% (1 in 44)
Risk of Placenta Accreta : 0.57% (1 in 165)
Risk of Major Complications : 7.5% (1 in 13)
Risk of Dense Adhesion’s : 32.2% (1 in 3)
3rd VBAC
Chance of Successful VBAC : 90.9% (9 in 10)
Risk of Uterine Rupture : 0.38% (1 in 263)
Risk of Hysterectomy : 0.06% (1 in 1667)
Risk of Blood Transfusion : 0.99% (1 in 101)
4th Cesarean
Risk of Hysterectomy : 2.41% (1 in 41)
Risk of Blood Transfusion : 3.65% (1 in 27)
Risk of Placenta Accreta : 2.13% (1 in 47)
Risk of Major Complications : 12.5% (1 in 8)
Risk of Dense Adhesion’s : 42.2% (2 in 5)
Note : “Major complications” include one of more of the following : uterine rupture, hysterectomy, additional surgery due to hemorrhage, injury to the bladder or bowel, thromboembolism, and/or excessive blood loss.
This is all great information that all women should know when making the choice of how they want to birth after having a cesarean birth.
I hope that some mothers with previous cesareans can truly benefit from this information!
Sources : Mercer, B. M., & Gilbert, S. et al. Labor Outcomes with increasing number or prior vaginal births after a cesarean delivery. Obstetrics & Gynocology 2008; 111: 285-291.
Silver, R.M, & Landom M. B., et al. Maternal morbidity associated with multiple repeat cesarean deliveres. Obstetrics & Gynocology. 2006; 107: 1226-1232.
Nisenblat, V., Barak, S., & Griness, O.B., et al. Maternal complications associated with multiple cesarean deliveres. Obstetrics & Gynecology 2006; 108: 21-6
Thinking about a C-section? 10 Things you should know
Go Back To Being Pregnant
4 Comments
snakecharmer commented on Jun 29 11 at 12:50 pmThank you for this information! I had an emergency C-section with my first child and now that I’m pregnant with my second, feel strongly about attempting a VBAC. There’s alot of misinformation out there about VBACs and the risks and it’s nice to see a reasonable point of view.
beckster commented on Jun 29 11 at 4:50 pmI had an unplanned c-section with my first and last fall gave birth via VBAC to my daughter. The most important thing you can do to ensure success is to advocate for yourself. Ask a ton of questions. If someone tells you no, ask why. I switched practices and hospitals to find a doctor that was willing to work with me instead of against me on my VBAC. Don’t let them scare you! It is possible. My VBAC birth was less traumatic and I recovered much quicker than I did from the c-section. I am so glad that I was willing to stand up for myself!
Katrina commented on Jun 29 11 at 5:08 pmNot ALL RCS are just because a woman wants another one. Sometimes the problems that created the first are present in second pregnancies. I had a c/s with my first because of preeclampsia and he was breech. We even tried turning him at 38 weeks.
Same situation this time around. I will be having a RCS in September due to blood pressure probs, the baby is breech, and I have a placental tumor this time around that can cause severe hemorrhaging.
I know I felt a tremendous amount of pressure and shaming tactics to attempt a VBAC. I just want other women/moms/people in general to stop judging every c/s mom before you know the circumstances. Very few women ‘choose’ to have a c/s the first time and there are many factors and risks to consider in subsequent pregnancies.
mamikaze commented on Oct 24 11 at 11:33 amThese numbers don’t take any variables into account. Maternal age and health are big players in these numbers I support VBAC and natural birth but I feel your presentation of these statistics could be done better.
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