How to Talk to Your Provider About VBAC

Looking for support and answers for your planned VBAC?

As you plan your next baby, or perhaps they are on their way now, growing fabulously, you may be considering a VBAC. If your plan is to VBAC or you want to consider VBAC for your delivery, how do you learn your options and talk with your provider about those options?

ACOG recommends that if your provider or facility does not support vbac, you be given information about a provider or facility that does.

A summary of the ACOG guidelines on VBAC can be seen below:

"VBAC is associated with decreased maternal morbidity and a decreased risk of complications with future pregnancies and births. With a VBAC women can avoid complications of multiple repeat cesareans including infection, blood transfusions, bowel and bladder injury, and placental complications (placenta previa, accreta, and percreta).

  • The risk of uterine rupture with one prior low-transverse uterine scar is low, 0.5% to 0.9%.
  • About 60 to 80 percent of women who labor after a prior cesarean have a VBAC.
  • Most women with one prior cesarean with a low-transverse uterine scar should be counseled about VBAC and offered a trial of labor.
  • Women with a twin pregnancy, an anticipated big baby, with two prior cesareans, and women who do not go into labor at term can still plan a VBAC.
  • With a breech, women can choose to have an external cephalic version (ECV) after the 37th week, an effective procedure that may turn a breech into a head-down position.
  • Care providers should discuss the risks and benefits of VBAC and routine repeat cesarean with their patients early in pregnancy and document it in their medical record. Source"

With the information above some women want to look deeper into what ACOG says about VBAC and what the specific guidelines are for women seeking consent and options. Seeing ACOGs guidelines women want to then open up a conversation with their provider about their options with their current pregnancy.

Research VBAC, your hospital options and ways to support your vbac

A great place to start is reading and reviewing the American College of Obstetrics and Gynecology (AGOC) guidelines for providers on safe vbac, who is a good candidate for vbac, what your options are, what the rupture risks and success rates are and more. This can lead you to researching other options like great providers in your area, support groups, and questions to ask when you talk to your provider.

Simply ask at your next prenatal

Once you have gathered some research, statistics, options, talk with your provider at your next prenatal. Ask them about their vbac statistics for women in similar situations as yourself, talk to them about their guidelines for vbac patients who are breech in the third trimester, talk to them about how supportive they are of vbac, talk to them about their repeat cesarean policy, talk to them about your personal questions or concerns like movement in labor, pain relief and so on. Research ways to help you achieve a VBAC.

What do you do if your provider isn't supportive of VBAC?

Some providers do not feel comfortable working with vbac patients or they have strict guidelines in place for vbac patients. Sometimes they want to be supportive, but the birthing facility is not. Talk to them about how supportive your facility is of VBAC. Talk to them about what they are willing to compromise on, why they practice how they practice and if they recommend a provider who is able to support your wishes. The key to excellent prenatal care is finding a provider that aligns with your philosophy and is open to communication. Communication is very important in that it allows you to be an active participant in your prenatal care. Communication also opens up doors for you to feel involved and excited about your care.

As a pregnant woman you have the ability to play an active role in your prenatal care and communicate with your provider. If you are seeking support in communicating and planning for your birth, consider a Doula to add to your prenatal team.