How Menopause Affects Your Mental Health
The emotional changes of menopause can catch many women off guard. Sudden mood swings, heightened anxiety, or low mood often are often rooted in hormonal shifts. Partnering with an OB/GYN can help!
Risks and Benefits of Vaginal Birth After Cesarean (VBAC)
Even if you always imagined a natural, vaginal birth, sometimes you or your doctor decide that a surgical cesarean section (C-section) is best for you and your baby. In fact, every year in the United States, about 1 million babies are delivered by C-section, in which your doctor delivers your baby through an incision in your uterus.
About 32% of expectant mothers opt for C-section. Maybe you needed yours for medical reasons. Or, you may have chosen the surgery to spare yourself and your baby the time and trauma of prolonged labor during a vaginal delivery.
Now you’re pregnant again, and you’re wondering if you’re stuck forever with C-section deliveries. Thanks to advances in medicine, vaginal birth after Cesarean (VBAC) is both safe and viable for many women.
When you’re pregnant, you want to ensure that you make the best choices for yourself and your baby. Dr. A. Michael Coppa in Cranston, Smithfield, and Providence, Rhode Island, wants the same. If you’ve had a C-section before, here’s what you need to know before selecting VBAC.
Why VBAC is safe
Years ago, the standard advice to women who had undergone C-section was to deliver all subsequent babies surgically, too. Physicians at the time were concerned that uterine contractions during labor for a vaginal delivery would stress the scar tissue in the uterus, leading to a high risk of uterine rupture.
But we’ve since learned that uterine rupture occurs in less than 1% of women who choose to attempt a trial of labor after cesarean (TOLAC). Even better, VBAC is successful for 75% of women who attempt a TOLAC after one C-section and for half of those who’ve had two C-sections.
Why VBAC may be best
It may quiet your concerns when you learn that VBAC has a number of advantages when compared with yet another C-section. These include:
Faster recovery
When you deliver successfully via VBAC, you don’t undergo surgery. You therefore have a shorter hospital stay and a quicker return to normal activities. Unlike C-section, VBAC doesn’t come with a high risk of heavy bleeding, infection, and bladder or bowel damage.
Repeat surgery is risky
Multiple C-sections weaken your uterus. Ironically, repeat cesareans increase your risk for uterine rupture, not VBAC. With multiple C-sections, you’re also at risk for rupture even before labor and delivery, due to the weakened state of your uterus.
Two or more C-sections increase your chance of developing placental problems, such as placenta previa or placenta accreta.
Your baby gets a boost
When your baby passes through your birth canal, the squeezing pressure helps clear amniotic fluid from their lungs, preparing them to breathe oxygen right away. Vaginal birth also allows you to pass on various healthy microbes to your baby. These microbes help fortify their immune system.
Potential VBAC risks
A successful VBAC has fewer risks of complications than elective repeat C-sections. But an unsuccessful VBAC may put you at risk of more serious complications.
Uterine rupture
The pressure of labor and a vaginal delivery could force your uterus to rupture along your scar line. Uterine rupture can be life-threatening for both you and your baby.
Hysterectomy
If you attempt VBAC and your uterine ruptures, your doctor must perform an emergency C-section. They then must treat you to stop excessive bleeding to save your life. This may include an emergency hysterectomy. Your doctor removes your uterus, so you won’t be able to get pregnant again.
Emergency C-section
During VBAC, you may need a C-section if your labor is so prolonged that it endangers you or your baby. Emergency C-sections tend to be riskier than planned cesarean births.
Is VBAC your best choice?
You and Dr. Coppa decide whether a new C-section or VBAC is your best and safest choice. You must meet a number of inclusion criteria to be a candidate for VBAC, including:
- No more than two previous cesarean deliveries
- Horizontal uterine incision was low (i.e., less likely to rupture)
- No other prior uterine surgeries
- No underlying condition that makes vaginal delivery risky
You’re also more likely to do well with VBAC if you had a prior successful vaginal birth or VBAC. Dr. Coppa may advise against VBAC if you:
- Had more than two cesarean births
- Had a vertical incision (i.e., the type most likely to rupture)
- Needed C-section due to nonprogressing labor
- Had your last baby in the past 18 months
- Experienced a failed VBAC or uterine rupture
Other factors that may weigh against VBAC include:
- Needing to be induced past your due date
- Age 35 years or older
- Being overweight or obese
- Being pregnant with multiples
Do you think VBAC may be best for you and your baby? Call our team or request an appointment online at the office nearest you for a VBAC consultation today.
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