Once a C, Always a C?
To C or Not to C
A time and place for each continued...
But VBAC isn't for everyone, Randell warns. If a woman has a
very narrow pelvis, any medical or obstetrical complication that precludes
vaginal delivery, or has had a "classical" c-section where the uterus
was cut up and down vs. side to side (note that the direction of the scar on
the skin does not accurately predict the one on the uterus, and a review of the
operative report is highly advisable to confirm such a detail), a VBAC is not
recommended. Ultimately, the decision is based on weighing risks and benefits,
says Randell, and each case is unique.
Women considering VBAC also must acknowledge the possibility
that despite the trial of labor, they may need to have another cesarean. For
these women, Mozurkewich says, recovery may take longer and be associated with
a higher risk of infection and other complications than with an elective C.
"If she has the baby vaginally, her recovery will be shorter, but if she
has a failed trial of labor, she will face the recovery of both the labor and
Just as a woman has the right to choose VBAC if it is medically
appropriate, she also has the right to refuse it, says Randell. Some women just
aren't comfortable with the risks, Randell says. Others prefer to schedule the
baby's arrival, fear vaginal childbirth, or have had a previous c-section and
want to go with the known. Likewise, if a woman is not a good candidate for
VBAC, her doctor can refuse. "The goal is to have a healthy baby and a safe
delivery, by whatever method," says Hundley. "That's most
A VBAC success
When Cheryl went into labor with her second child, the thought
did cross her mind that she might still need another cesarean. But after a
short labor and 45 minutes of pushing, her daughter was born vaginally without
any problems. "I would recommend VBAC to anyone who wants to try," she
says. "I'd choose it again in a minute."
Michele Bloomquist is a freelance writer based in Brush
Prairie, Wash. She was born by elective c-section, in the days before VBAC.