VBAC: When to Push and When to Cut

Birth can be a complex experience, it can be an overwhelming and exhausting miracle. The birthing process has changed over many years, and more women give births through Caesarean section. In 2009, 32.9% of births in the US were completed by Caesarean section (1). If a woman receives a caesarean section, the next option of childbirth is to repeat the caesarean section or try a birth (VBAC) that may lead to vaginal delivery after caesarean section. Both alternatives have risks and benefits, but each option should be presented to the patient in an educated manner.

Vaginal delivery (VBAC) after caesarean section is the practice of vaginal delivery (surgery) after caesarean section before delivery. According to the American College of Obstetrics and Gynecology (ACOG), a successful VBAC is associated with a reduction in maternal morbidity and a reduction in the risk of future pregnancy complications. According to the American Pregnancy Association, 90% of women who received caesarean section are candidates for VBAC. Approximately 60 to 80% of women who selected VBAC have successfully delivered to the vagina, which is comparable to the vaginal delivery rate in the US in 2010.

A woman who had previously undergone a caesarean section is not permitted to deliver to the vagina at all hospitals. According to a hospital spokesperson, Dray has chosen to lay her child at SIUH, because it supports VBAC and the caesarean section rate is lower than the statewide average. However, after Dray gave birth, she insisted that her doctor pressured her again to perform a cesarean section again. "I did not do it for you all day," she remembered the doctor. "If you do not make me caesarean section, the state government will take your baby away." (The hospital refused to comment on whether her doctor made this statement.)

For the second time, I tried VBAC (vaginal deliveries after caesarean section) because I was interested in labor (again afraid of surgery). About 60 hours of work (my curiosity, it was very satisfying!), 3 hours push, 103 degrees fever, I finally shouted to my midwife. Through medical decision she has applied the structure of the story to my infinite experience: before we entered the operating room, we received two suction aids.