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The Pros and Cons of VBAC

An Updated Look at Vaginal Birth After Cesarean

By Lisa A. Goldstein

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"Vaginal Birth After Cesarean in California: Before and After a Change in Guidelines," an article which appeared in the May/June 2006 issue of the Annals of Family Medicine, also provides an interesting statistic: "Our findings suggest that women expecting to give birth to normal – or large – birth-weight infants can anticipate similar neonatal mortality with a VBAC or a repeat Cesarean section."

Pros and Cons of VBAC
Getting down to the details, what are the pros and cons of a VBAC?

"The cons are mainly when there is a disastrous outcome," Dr. Evans says. One in 100 women rupture their uterus. One in a thousand patients or their babies die as a result. An additional one or two in 1,000 require transfusions, repair of bladder or bowel lacerations and sometimes hysterectomies, Dr. Evans says.

"The pros of having a successful VBAC are shorter recovery from delivery," Dr. Evans says. "Repeat Cesarean sections increase the patient's risk of having placenta previa and placenta accreta."

What the general public doesn't realize is that VBAC should be performed only in hospitals where there is access to immediate Cesarean section, Dr. Evans says. Many community hospitals don't have anesthesiologists available 24 hours a day along with the obstetrician in house for the whole labor.

As for Thompson, her doctor was very supportive. As long as she was continuously monitored, her doctor was comfortable with the VBAC, as was she. She assembled a birth team to help do everything possible to have a VBAC. Because of the safety measures undertaken, Thompson felt entirely comfortable taking the slight risk of having a VBAC.


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