The New York Times has recently reported that the American College of Obstetricians and Gynecologists has begun to loosen the guidelines permitting Vaginal-Birth After Caesarian (VBAC). The New Yorks Times seems to see this as a step in the right direction, although VBAC is a potentially dangerous situation which any patient considering the procedure needs to be aware of.
First, VBAC may be contraindicated based upon the type of incision used in any prior C-section. Be sure that only a "low transverse" incision was used.
Second, the American College of Obstetricians and Gynecologists have used the term "immediately available" to near to a VBAC an OB doctor should be when a patient is undergoing a VBAC. This amorphous terms should mean that an OB is in the hospital ready to actually perform a C-section in less than fifteen minutes. This is because soon after fifteen minutes have passed following a uterine rupture, it is believed that irreversible brain damage begins to set in.
Third and finally, be wary of any induction during a trial of labor, especially the use of off-label medications such as Cytotec a/k/a misoprostol. Induction agents may further increase the risk of uterine rupture in any VBAC, and these risks are often not explained adequately to the patient.
Whether a mother should elect VBAC or not is based on several factors, but if you are considering either VBAC or a trial of labor, be sure to press your doctor or midwife excessively about the risks involved, the medications that will be used, and how soon a medical doctor can be called to perform an emergent C-section if signs of uterine rupture beging to show.
3 Comments
Heather
Yeah! This is a great move by them. I am looking forward to my upcoming VBAC this October and I am glad they have done this so more woman can have a VBAC!
Jonathan Nace
Heather:
Nothing wrong with having a VBAC, per se. Be sure all your questions are answered satisfactorily though, and be sure there is competent fetal and uterine monitoring during any trial of labor. Congratulations on the child!
Heather
Oh yes! I have lots of questions, I am doing lots of research, and understand that if the baby or I am not doing well that a c-section may be necessary. But thanks!
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