{"id":41,"date":"2015-08-06T00:57:44","date_gmt":"2015-08-06T00:57:44","guid":{"rendered":"http:\/\/www.ican-online.org\/cbac\/?page_id=41"},"modified":"2017-09-07T08:57:42","modified_gmt":"2017-09-07T08:57:42","slug":"how-does-a-cbac-affect-women","status":"publish","type":"page","link":"https:\/\/www.ican-online.org\/cbac\/how-does-a-cbac-affect-women\/","title":{"rendered":"How Does a CBAC Affect Women?"},"content":{"rendered":"<p class=\"wsite-content-title\"><span style=\"color: #000000; font-size: medium;\"><span style=\"color: #000000; font-size: medium;\">Unfortunately, not all women who want a VBAC will have one.<\/span><\/span><\/p>\n<p>On average, in a typical high-intervention hospital setting, 60-80% of women who try for a VBAC will have one\u00a0(<em>Grobman 2010<\/em>). This means that about 20-40% will have a CBAC instead.<\/p>\n<p>Although these rates can be improved by carefully selecting lower-intervention care providers (<em>Rusillo 2008, Avery 2004<\/em>) and avoiding many common interventions (<em>Catling-Paull 2011<\/em>), the VBAC rate, alas, will never be 100%. Yet the experiences of women who did not get a much-desired VBAC has been significantly understudied.<\/p>\n<p><span style=\"color: #000000; font-size: medium;\">How are the women who do not get a VBAC impacted afterwards? How do they feel about their CBAC experience? Do they regret having tried for a VBAC? Would they want to try again? What does the research say about the emotional impact of a CBAC?<\/span><\/p>\n<p><strong><span style=\"color: #8d5024; font-size: x-large;\">How Do Women Feel About Their CBACs?<\/span><\/strong><\/p>\n<p><span style=\"color: #000000;\">One study surveyed women who had CBACs (<\/span><em>Chigbu 2007<\/em><span style=\"color: #000000;\">) and asked them about their emotional responses to it. This survey indicated that CBAC mothers felt:\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Dashed expectations<\/li>\n<li>Feelings of inadequacy as a mother<\/li>\n<li>Frustration with experiencing the pain and trauma of both labor and surgery.<\/li>\n<\/ul>\n<p><span style=\"color: #2a2a2a; font-size: medium;\">Women with a prior vaginal birth before the CBAC had more positive assessments than those without a prior vaginal birth, but all women were affected to some degree.<\/span><\/p>\n<p><span style=\"color: #000000; font-size: medium;\">Another study (<em>Shorten and Shorten 2012<\/em>) differentiated the emotional responses of women by final mode of delivery. Unsurprisingly, women who had a spontaneous VBAC reported the most satisfaction. Women who had instrumental births (forceps or vacuum extractor) or a cesarean during labor reported the least satisfaction, compared with women who had a spontaneous VBAC (the highest satisfaction score) or an Elective Repeat Cesarean Section (ERCS). Interestingly, women who had an instrumental VBAC had lower satisfaction scores than women who had a cesarean in labor. Since\u00a0instrumental delivery can be invasive and may involve perineal damage, this may be the source of dissatisfaction.<\/span><\/p>\n<p><span style=\"font-size: medium;\"><span style=\"color: #000000;\"><strong>This points out the importance of offering emotional support both to women who have a CBAC and to those who have had a traumatic VBAC. <\/strong>Few resources exist that specifically address the needs of either group of women. CBAC mothers&#8217; needs are assumed to be the same as the woman who had an unexpected primary cesarean, when in reality, her needs are often different. And many people assume that as long as the mother got a VBAC, everything will be fine, when in reality, trauma and ambivalent feelings can happen even in VBAC moms. More research is needed on how best to offer support to women in <\/span><em>both <\/em><span style=\"color: #000000;\">of these groups.<\/span><\/span><\/p>\n<p><span style=\"color: #000000;\">What about the popular perception among healthcare providers that most CBAC moms wish afterwards that they had just chosen a repeat cesarean? Some women do wish this, but often it&#8217;s a passing reaction to the disappointment of the birth and the difficulty of dealing with both a hard labor and a surgical recovery. The Shorten study asked women their reactions 6-8 weeks after the birth, whereas some of the other studies asked women their perceptions years later; h<\/span><span style=\"color: #000000; font-size: medium;\">ow women feel about their CBAC often depends on when they are asked about it.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000; font-size: medium;\">What we&#8217;ve seen in ICAN is that immediately afterwards, it&#8217;s not uncommon for CBAC mothers to wish they&#8217;d just had a repeat cesarean. But given more time, many women report that they were glad that they had a trial of labor, even if it didn&#8217;t end in a VBAC.<\/span><\/p>\n<p>This is supported in the research. For example, Cleary-Goldman 2005 found that, although disappointed at not having a VBAC, 92% of women who had a CBAC \u201cwere pleased that they had attempted a vaginal birth.\u201d\u00a0 They concluded:<\/p>\n<p style=\"padding-left: 30px;\"><span style=\"color: #800000;\"><em>Although the most satisfied patients were those who succeeded at vaginal birth, most women valued the opportunity to <\/em><em>attempt a vaginal birth regardless of outcome<\/em>.<\/span><\/p>\n<p>This was a result also found by Phillips (2009). Indeed, Chigbu (2007) noted, &#8220;<em>This survey revealed that most women still would prefer to be delivered vaginally after 2 previous cesarean deliveries.&#8221;\u00a0<\/em>This reflects the reality that many women would still choose to have another chance at\u00a0VBAC, even after having had a CBAC.<br \/>\n<span style=\"color: #000000;\"><br \/>\n<span style=\"font-size: medium;\">However, each woman is different and there is no &#8220;right&#8221; way to feel about a CBAC. Each person&#8217;s experience is unique and her feelings about it perfectly valid. \u00a0<\/span><\/span><\/p>\n<p><strong><span style=\"color: #8d5024; font-size: x-large;\">Improving Support for CBAC Mothers<\/span><\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: medium;\"><span style=\"color: #000000;\">There remains much work to be done on how to improve support for women who have had a CBAC. This work needs to acknowledge the uniqueness of each mother&#8217;s situation and provide support specific to her needs.<\/span><\/span><\/p>\n<p>For example, many people in the birth field assume that the best way to heal a CBAC is to have a VBAC. Yet while a VBAC can be healing, it never makes the reality of a CBAC completely go away. Sometimes a VBAC can make a CBAC experience even more painful in retrospective as the mother processes the CBAC in a new and different way.<\/p>\n<p>Furthermore, in some women a VBAC is medically contraindicated, the woman is done having children, cannot find a supportive provider, or does not wish to labor again. Little research has been done on how to support women who will never have a VBAC. They also need help integrating their experiences into their lives.<\/p>\n<p><span style=\"color: #000000;\">In addition, information is desperately needed on how best to support women who experienced any sort of birth trauma, whatever the source (<em>Beck and Watson, 2010<\/em>). Although many grassroots organizations like <\/span><a title=\"\" href=\"http:\/\/www.solaceformothers.org\" target=\"_blank\"><span style=\"color: #000000; font-size: medium;\">Solace for Mothers<\/span><\/a><span style=\"color: #000000; font-size: medium;\"> and <\/span><a title=\"\" href=\"http:\/\/www.tabs.org.nz\" target=\"_blank\"><span style=\"color: #000000; font-size: medium;\">TABS<\/span><\/a><span style=\"font-size: medium;\"><span style=\"color: #000000;\">\u00a0(Trauma and Birth Stress) exist to support women after traumatic births, little research has been done into the efficacy of their approaches.<\/span><\/span><\/p>\n<p>The few surveys on CBAC that have been done show the emotional impact a CBAC (or traumatic VBAC) can have, but the topic is glaringly understudied. More research is needed on the experiences of these mothers and what can be done to help support them.<\/p>\n<p><span style=\"color: #000000;\">As Chigbu (2007) concluded:<\/span><\/p>\n<p style=\"padding-left: 30px;\"><em><span style=\"color: #800000;\">Maternity caregivers should understand the varied emotional and psychological impact of an unsuccessful trial of VBAC. <\/span><\/em><span style=\"color: #800000;\"><em>Following an unsuccessful trial of VBAC women should be given targeted psychological support to improve their overall<\/em><em> experience, especially those who have never been delivered vaginally.<\/em><\/span><\/p>\n<p><strong><span style=\"color: #508d24; font-size: x-large;\">References\u00a0<\/span><\/strong><\/p>\n<p><span style=\"font-size: small;\"><span style=\"color: #000000;\">Grobman WA \u00a0<em>Rates and prediction of successful\u00a0vaginal birth after cesarean.<\/em>.\u00a0Semin Perinatol.\u00a02010 Aug;34(4):244-8. \u00a0PMID:\u00a0<\/span><a title=\"\" href=\"http:\/\/www.pubmed.gov\/20654774\" target=\"_blank\"><span style=\"color: #000000;\">20654774<\/span><\/a><\/span><\/p>\n<p>Russillo B,\u00a0Sewitch MJ,\u00a0Cardinal L,\u00a0Brassard N.J\u00a0<em>Comparing rates of trial of labour attempts,\u00a0VBAC\u00a0success, and fetal and maternal complications among family physicians and obstetricians<\/em>.\u00a0Obstet\u00a0Gynaecol Can.\u00a02008 Feb;30(2):123-8. PMID: <a title=\"\" href=\"http:\/\/www.pubmed.gov\/18254993\" target=\"_blank\"><span style=\"color: #000000;\">18254993<\/span><\/a><\/p>\n<p>Avery MD,\u00a0Carr CA,\u00a0Burkhardt P. \u00a0<em>Vaginal birth after cesarean\u00a0section: a pilot study of outcomes in women receiving\u00a0midwifery\u00a0care.<\/em>\u00a0J\u00a0Midwifery\u00a0Womens Health.\u00a02004 Mar-Apr;49(2):113-7. PMID:\u00a0<a title=\"\" href=\"http:\/\/www.pubmed.gov\/15010663\" target=\"_blank\"><span style=\"color: #000000;\">15010663<\/span><\/a><\/p>\n<p><span style=\"color: #000000;\">Catling-Paull C,\u00a0Johnston R,\u00a0Ryan C,\u00a0Foureur MJ,\u00a0Homer CS. \u00a0<em>Clinical interventions that increase the uptake and\u00a0success\u00a0of\u00a0vaginal\u00a0birth\u00a0after\u00a0caesarean section: a systematic review.\u00a0<\/em> J Adv Nurs.\u00a02011 Aug;67(8):1646-61. doi: 10.1111\/j.1365-2648.2011.05635.x. Epub 2011 Apr 8. \u00a0PMID:\u00a0<\/span><a title=\"\" href=\"http:\/\/www.pubmed.gov\/21477118\" target=\"_blank\"><span style=\"color: #000000;\">21477118<\/span><\/a><\/p>\n<p>Chigbu CO, Enwereji JO, Ikeme AC.\u00a0 <em>Women\u2019s experiences following failed vaginal birth after cesarean delivery.<\/em> Int J\u00a0Gynaecol\u00a0Obstet 2007 Nov;99(2):113-6.\u00a0\u00a0 PMID: <a title=\"\" href=\"http:\/\/www.pubmed.gov\/17662288\" target=\"_blank\"><span style=\"color: #000000;\">17662288<\/span><\/a><\/p>\n<p><span style=\"color: #000000;\">Shorten A,\u00a0Shorten B.\u00a0<em>The importance of mode of\u00a0birth\u00a0after\u00a0previous\u00a0cesarean:\u00a0success, satisfaction, and postnatal health.\u00a0<\/em>J Midwifery Womens Health.\u00a02012 Mar-Apr;57(2):126-32. doi: 10.1111\/j.1542-2011.2011.00106.x. Epub 2012 Feb 9. \u00a0PMID:\u00a0<\/span><a title=\"\" href=\"http:\/\/www.pubmed.gov\/22432483\" target=\"_blank\"><span style=\"color: #000000;\">22432483<\/span><\/a><\/p>\n<p>Cleary-Goldman J,\u00a0Cornelisse\u00a0K, Simpson LL, Robinson JN. <em>Previous cesarean delivery: understanding and satisfaction with mode of delivery in a subsequent pregnancy in patients participating in a formal vaginal birth after cesarean counseling program.\u00a0 <\/em>Am J Perinatol. 2005 May;22(4):217-21.\u00a0 PMID: <a title=\"\" href=\"http:\/\/www.pubmed.gov\/15906216\" target=\"_blank\"><span style=\"color: #000000;\">15906216<\/span><\/a><\/p>\n<p><span style=\"color: #000000;\">Phillips E, McGrath P, Vaughan G.\u00a0 <em>\u2018I wanted desperately to have a natural birth\u2019: Mothers\u2019 insights on Vaginal Birth After Caesarean (VBAC). <\/em>\u00a0Contemporary Nurse 2009 Dec-2010 Jan:34(1):77-84. PMID: <\/span><a title=\"\" href=\"http:\/\/www.pubmed.gov\/20230174\" target=\"_blank\"><span style=\"color: #000000;\">20230174<\/span><\/a><\/p>\n<p><span style=\"color: #000000;\">McGrath P,\u00a0Phillips E,\u00a0Vaughan G.\u00a0<em>Speaking out! Qualitative insights on the experience of mothers who wanted a\u00a0vaginal\u00a0birth\u00a0after\u00a0a birth\u00a0by\u00a0cesarean\u00a0section.\u00a0<\/em><br \/>\nPatient.\u00a02010 Mar 1;3(1):25-32. PMID:\u00a0<\/span><a title=\"\" href=\"http:\/\/www.pubmed.gov\/22273273\" target=\"_blank\"><span style=\"color: #000000;\">22273273\u00a0<\/span><\/a><\/p>\n<p><span style=\"color: #000000;\">Beck CT, Watson S. <em>Subsequent childbirth after a previous traumatic birth. <\/em>Nurs Res 2010 Jul-Aug;59(4):241-9. PMID: <\/span><a title=\"\" href=\"http:\/\/www.pubmed.gov\/20585221\" target=\"_blank\"><span style=\"color: #000000;\">20585221<\/span><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Unfortunately, not all women who want a VBAC will have one. On average, in a typical high-intervention hospital setting, 60-80% of women who try for a VBAC will have one\u00a0(Grobman 2010). This means that about 20-40% will have a CBAC instead. 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Although these rates can be improved by carefully selecting lower-intervention care providers (Rusillo 2008,"},"aioseo_meta_data":{"post_id":"41","title":null,"description":null,"keywords":null,"keyphrases":null,"primary_term":null,"canonical_url":null,"og_title":null,"og_description":null,"og_object_type":"default","og_image_type":"default","og_image_url":null,"og_image_width":null,"og_image_height":null,"og_image_custom_url":null,"og_image_custom_fields":null,"og_video":null,"og_custom_url":null,"og_article_section":null,"og_article_tags":null,"twitter_use_og":false,"twitter_card":"default","twitter_image_type":"default","twitter_image_url":null,"twitter_image_custom_url":null,"twitter_image_custom_fields":null,"twitter_title":null,"twitter_description":null,"schema":{"blockGraphs":[],"customGraphs":[],"default":{"data":{"Article":[],"Course":[],"Dataset":[],"FAQPage":[],"Movie":[],"Person":[],"Product":[],"ProductReview":[],"Car":[],"Recipe":[],"Service":[],"SoftwareApplication":[],"WebPage":[]},"graphName":"","isEnabled":true},"graphs":[]},"schema_type":"default","schema_type_options":null,"pillar_content":false,"robots_default":true,"robots_noindex":false,"robots_noarchive":false,"robots_nosnippet":false,"robots_nofollow":false,"robots_noimageindex":false,"robots_noodp":false,"robots_notranslate":false,"robots_max_snippet":null,"robots_max_videopreview":null,"robots_max_imagepreview":"large","priority":null,"frequency":null,"local_seo":null,"breadcrumb_settings":null,"limit_modified_date":false,"ai":null,"created":"2025-08-13 09:51:57","updated":"2025-08-13 09:51:57","seo_analyzer_scan_date":null},"aioseo_breadcrumb":"<div class=\"aioseo-breadcrumbs\"><span class=\"aioseo-breadcrumb\">\n\t\t\t<a href=\"https:\/\/www.ican-online.org\/cbac\" title=\"Home\">Home<\/a>\n\t\t<\/span><span class=\"aioseo-breadcrumb-separator\">&raquo;<\/span><span class=\"aioseo-breadcrumb\">\n\t\t\tHow Does a CBAC Affect Women?\n\t\t<\/span><\/div>","aioseo_breadcrumb_json":[{"label":"Home","link":"https:\/\/www.ican-online.org\/cbac"},{"label":"How Does a CBAC Affect Women?","link":"https:\/\/www.ican-online.org\/cbac\/how-does-a-cbac-affect-women\/"}],"_links":{"self":[{"href":"https:\/\/www.ican-online.org\/cbac\/wp-json\/wp\/v2\/pages\/41","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ican-online.org\/cbac\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ican-online.org\/cbac\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ican-online.org\/cbac\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ican-online.org\/cbac\/wp-json\/wp\/v2\/comments?post=41"}],"version-history":[{"count":4,"href":"https:\/\/www.ican-online.org\/cbac\/wp-json\/wp\/v2\/pages\/41\/revisions"}],"predecessor-version":[{"id":199,"href":"https:\/\/www.ican-online.org\/cbac\/wp-json\/wp\/v2\/pages\/41\/revisions\/199"}],"wp:attachment":[{"href":"https:\/\/www.ican-online.org\/cbac\/wp-json\/wp\/v2\/media?parent=41"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}