VBAC

A VBAC is a Vaginal Birth After Cesarean.  I first learned about VBACs from an article in Time magazine called The Trouble With Repeat Cesareans.

There is a great deal of controversy surrounding VBACs, and many hospitals do not give women who have had a previous c-section an option of a VBAC - its more cesareans only forever.  More than 9 out of 10 births following a C-section are now surgical deliveries.

The main risk associated with a VBAC is Uterine Rupture (because the mothers uterus has a huge cut scar running down it from her cesaren), which can be fatal to both mom and baby.

Here are the risks of Repeat Cesareans:
Heavy bleeding/hemorrhage
Increased risk of infection and infertility
Increased risk for hysterectomy and  uterine rupture in subsequent pregnancies
Increase a woman's chances of developing life-threatening placental abnormalities that can cause hemorrhaging during childbirth, such as placenta accreta (in which the placenta attaches abnormally to the uterine wall)

From Birth, Babies and Everything In Between:

Without a compelling reason for surgery, VBAC in most cases is safer not only for mom, but also for the baby. While there is a risk of uterine rupture, for women with low, transverse uterine scars, the risk is 0.6% meaning less than 1 full percent. But in many cases, what we fail to take into the account is the risk for uterine rupture during any time of any subsequent pregnancy after having a cesarean. But most providers fail to tell you this, especially if they are an Obstetrician who would rather you schedule your birth. But no one is going to tell you that you are more likely to be hit by a car or struck by lightening than to suffer a uterine rupture which is the biggest fear of VBAC.

Here are some numbers:

1st VBAC
Chance of Successful VBAC : 63.3% (2 in 3)
Risk of Uterine Rupture : 0.87% (1 in 115)
Risk of Hysterectomy : 0.23% (1 in 435)
Risk of Blood Transfusion : 1.89% (1 in 53)

          vs.

2nd Cesarean
Risk of Hysterectomy : 0.42% (1 in 238)
Risk of Blood Transfusion : 1.53% (1 in 65)
Risk of Placenta Accreta : 0.31% (1 in 325)
Risk of Major Complications : 4.3% (1 in 23)
Risk of Dense Adhesion's : 21.6% (1 in 5)

So why do doctors push repeat cesareans instead of risking VBACs?
Malpractice Insurance.

Following a few major lawsuits stemming from VBAC cases, many insurers started jacking up the price of malpractice coverage for ob-gyns who perform such births. In a 2006 ACOG survey of 10,659 ob-gyns nationwide, 26% said they had given up on VBACs because insurance was unaffordable or unavailable; 33% said they had dropped VBACs out of fear of litigation. "It's a numbers thing," says Dr. Shelley Binkley, an ob-gyn in private practice in Colorado Springs who stopped offering VBACs in 2003. "You don't get sued for doing a C-section. You get sued for not doing a C-section."

Here is a link to a video which is really just a photo montage of a woman's journey from a cesarean to a VBAC at home. Its also a water birth!