VBAC: What is it? Is it available in Bozeman, Montana?

The idea of having a Vaginal Birth After a previous Cesarean (VBAC) is one that seems to be controversial among many health care providers. Some midwives will allow their clients to opt out of getting a second c-section if certain precautions are taken, whereas many medical doctors and OB/GYNs prefer for their patient to have a second cesarean.

If you have had a previous c-section and are interested in the possibility of having a VBAC, ASK QUESTIONS! Learn the facts before letting your medical provider dissuade you from having the birth you want (as long as precautions are taken, and you are at low risk).

Here are some common guidelines to keep in mind when considering VBACs.

1. Parents have discussed all of the pros and cons regarding having a VBAC with their doctor

2. The current pregnancy does not show any indications for necessitating a cesarean

3. In the previous cesarean, a low transverse incision was used

4. The mother is admitted to the hospital EARLY during labor and is carefully monitored throughout labor and delivery

5. Facilities are set up for an immediate c-section if needed

Other issues to keep in mind:

a. Some doctors will not allow a VBAC is the previous cesarean was due to a small pelvic cavity

b. Some doctors won't use drugs to stimulate labor is a previous c-section was performed

c. Some doctors will not use a regional anesthesia during a VBAC since it may mask symptoms of rupture issues

d. Some doctors recommend using low forceps to decrease labor time

If a cesarean is inevitable, Cesarean Support Groups recommend the following:

* Allow the mother to refuse preoperative medications

* Allow the mother to receive regional anesthesia so that she can watch the baby being born

* Use an epidural, if an anesthesiologist is present

* Perform the operation with a low transverse incision, when possible

* Let the father be with the mother in the delivery room

* Let the mother have her arms free

* Let the mother view the birth without a screen, or with a mirror

* Encourage the doctor to encourage the parents and reassure them during the surgery

* Allow the mother, and or father, hold the baby immediately after birth

* Let the parents watch during the initial pediatric exam

* Allow for an initial bonding period before rushing to weigh, measure and administer eye drops

* Let the new family be together in the recovery room for the first hour after birth

* Let the mother nurse the baby as soon as the operation is complete

Some helpful websites:

Internation Cesarean Awareness Network

WebMD