Although induction may seem like a good option and is not prohibited in VBAC labors, induction may pose a greater risk for women hoping to experience a VBAC. Induction can increase the risk of uterine rupture and women who undergo an induction of labor with a prior cesarean have a 33-75% risk of requiring another cesarean. It is important to weigh the risks and benefits and carefully consider the reason for a suggested induction. An induction should only be considered when an induction is medically warranted.

Many women have delivered their babies vaginally, even with more than one prior cesarean. A vaginal birth after multiple cesareans, for many woman, may be the safest option. It is important that a woman is well-educated and informed before making the choice to VBAC after multiple cesareans.

No hospital and no physician has the right to force you to have surgery that you do not want to have. If you do not consent to the surgery, they cannot operate on you and they cannot demand you to allow them to. If you feel you are being pressured or forced into having a cesarean you can find valuable information on ICAN’s website with suggestions on how to address and handle the situation.

Many hospitals have bans on VBACs or bans on VBACs after multiple cesareans. These bans can make it harder for women to have a VBAC, however, these bans do not mean that the woman must submit to a repeat cesarean. Every patient has the right to refuse treatment. This includes the right of a pregnant woman to refuse another cesarean. Even if a ban is in place, a hospital cannot turn away a mother in labor and will be forced to care for her to the best of their ability, despite her refusal of the cesarean.

Each and every pregnancy is different and it is important for women to evaluate their own situation carefully with the assistance and guidance of a trusted caregiver. Although there are some specific definitions set in place by organizations such as ACOG defining who is and isn’t considered a “good candidate” for a trial of labor after cesarean, it should be determined based on each woman’s specific circumstances whether or not a VBAC is the best option.

When discussing a VBAC, the primary concern of any individual is that of uterine rupture. Uterine rupture occurs when a separation of the uterine wall occurs at the scar of the previous cesarean. Uterine rupture can be life-threatening and serious, however, the risk of uterine rupture occurring is very rare, affecting less than 1% of women who attempt a VBAC. After a woman has had a VBAC, her risk of uterine rupture decreases more with each vaginal delivery.

As the meaning behind the acronym implies, a VBAC is a vaginal birth after a prior cesarean. A woman who has had a VBAC was able to deliver her baby vaginally without surgical intervention, even with a prior cesarean. Many women who attempt a VBAC will go on to have their babies vaginally.

The term “VBAC” is an acronym for vaginal birth after cesarean. Other variations of this acronym may be used to describe more specific birth situations, such as HBAC (home birth after cesarean), or VBA2C (vaginal birth after two cesareans).

Obstetrical emergencies like:
-prolapsed cord (where the cord comes down before the baby)
-placental abruption (where the placenta separates before the birth)
-placenta previa (where the placenta partially or completely covers the cervix)
-placenta accreta (where the placenta is too deeply embedded in the uterine wall and has potential for maternal hemorrhage)
-eclampsia/pre-eclampsia (pregnancy-induced high blood pressure, causes severe swelling due to water retention, and can impair kidney and liver function. If it progresses to eclampsia, toxemia is potentially fatal for mother and child.)

Other common reasons we hear for cesarean are:
-fetal malpresentation such as transverse lie or breech (many women are not given a full range of options such as vaginal breech birth with a skilled provider or external cephalic version to turn a malpositioned baby)
-suspected cephalopelvic disproportion aka CPD – (meaning that the head is too large to fit through the pelvis. Actual condition is very rare. This is often over diagnosed, and many women do go on to have vaginal births after a cesarean for CPD)
-Maternal medical conditions (active herpes lesion, severe hypertension, diabetes, etc.)
-fetal distress. (This is a hot topic with the recent studies indicating that continuous electronic fetal monitoring increases the cesarean rate and does not show a relative increase in better outcomes. Discuss with your care provider how they define fetal distress and what steps are used to remedy the situation before a cesarean.)