If you have had a cesarean birth (C-section) in the past, you may have questions about VBAC (vaginal birth after cesarean). Many expectant moms also have questions about their chance of having a C-section. Our OB/Gyns have put together helpful information about these commonly asked questions. Their answers can help empower you to work together with your doctor to make the decisions right for you.

"How often are C-sections performed at Hendricks Regional Health?"

Our cesarean birth (C-section) rate is at the national norm, about one in three. Cesarean births are sometimes necessary for the safety of mother and baby. Some cesareans are scheduled in advance when the physician anticipates a problem delivery, for instance, the placenta is located low in the uterus (placenta previa), the baby is in a breech position (not head down), or if the mother's pelvis is too narrow for the baby to be born vaginally. Other cesarean births may not be planned, but are needed after unsuccessful labor. Many women who have had a cesarean delivery previously will need a cesarean for subsequent births, but this decision will always be discussed with the patient.

"I had a C-section for my last delivery. Can I do a VBAC?"

We handle vaginal birth after cesarean (VBAC) requests on an individual basis. Because of potential risks, each case must be evaluated by an OB/Gyn who works with you to determine the feasibility of a VBAC. There are many factors that may or may not make a VBAC possible. Our first concern is the health and safety of both mother and baby, and VBAC carries risks that many women and doctors are not comfortable taking.

The biggest concern with a VBAC is the risk of uterine rupture, prompting the need for an immediate cesarean section and hysterectomy. Because VBACs have the potential to rupture the uterus and possibly lead to a tragic situation for mother and baby, several leading medical groups now call for a surgeon and anesthesiologist to be present during the entire labor of a woman attempting a VBAC in case life-saving, immediate action is required.

If your current pregnancy and health history put you in the lower-risk category, you might be a candidate for a VBAC. Only women fitting the following criteria can consider a VBAC delivery:

• if you have had one cesarean birth using a low transverse incision (a horizontal incision low in the uterus) AND all of the following:
• Your baby is full-term, normal in size and in the head-down (vertex) position.
• Labor has started on its own (spontaneously) and your cervix is dilating well.
• You have no medical reason for a cesarean delivery with this pregnancy, including placenta previa, breech position, narrow pelvis, multiples, or active genital herpes.
• You want to attempt a vaginal delivery.
• You deliver in a hospital that offers VBAC, such as Hendricks Regional Health, and has the ability to do a rapid emergency C-section if the need arises.

VBAC is not considered safe if you have no access to a hospital that can offer close monitoring and is equipped to handle an emergency cesarean delivery.