I'm getting ready to head off into a week of extremely limited internet access, but before I go, I have to share a great post on VBAC resources by Knitted in the Womb. The question comes up regularly for anyone involved in birth advocacy, even for me, and I'm not even an official anything birth-related just yet. Knitted in the Womb begins:
A friend recently asked me to pass along some information to help a friend of hers decide whether or not to pursue VBAC. This was my answer to her:I would add to this that it may be helpful to find out (if she doesn't already know) whether her incision was stitched with double-layer sutures, which some practitioners believe is important to VBAC, though there is some controversy over whether or not single-layer sutures should rule out VBAC as a possibility. Regardless, it's good to read up on for yourself in either case. Knitted then addresses the matter of uterine rupture in great detail, breaking down some statistics and dispelling some misconceptions. She includes some very important questions to address with one's care provider.
That can be a tough decision for many women!
The reason for her previous cesarean is important to consider in assessing her odds of having a vaginal birth this time around. If it was for twins, breech or fetal distress; then it had nothing to do with her ability to birth vaginally, and she is a good candidate for a VBAC (assuming a low transverse incision). If she had her cesarean for “failure to progress” (FTP) at a low dialation, many women think they are not good candidates for VBAC, but actually, the research shows that they are MORE likely to successfully VBAC than a woman who had a cesarean for FTP at a high dialation…simply because the cesarean was probably called before there was even a chance to find out if her body could do it! Not to say that a woman who had FTP at a high dialation can’t have a VBAC…one of my clients pushed for 3 hrs with her first baby and then had a cesarean, only to have a VBAC with a baby that was 11 oz bigger than her first baby–and no tearing as well.
She then goes on to share some good linkage, including VBAC Facts (which is the source of a very handy VBAC Facts card), some great books, and of course ICAN. I would add to this list the My Best Birth website and the "Your Best Birth" book itself, as well as this page (and anything else) on The Unnecesarean's blog. All of the above combined adds up to an immense amount of practical AND empowering information.
I refer people to VBACFacts all the time. That's a great site.
ReplyDeleteI always struggle to answer the questions for people who want to have more information about their chances of a successful VBAC...mostly they want to know if their cousins next door neighbor's daughter is a good candidate, but they have almost no info about the primary c-s. I do find it amazing how little info is "freely given" to mom's from their OB's on this subject. Many of them have no idea what type of incision they have, what type of suturing was used etc...it seems that should all be disclosed to momma's since future pregnancies and births depend on that info. Thanks for posting these great links!
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