Tips for planning a vaginal birth after a Caesarean birth

Most women who've undergone a previous Caesarean are candidates for a vaginal birth after a Caesarean birth (VBAC). Yet in 2000, only about 20 percent of eligible women went through with it. Given that the success rate is 60 percent to 80 percent, why don't more women choose VBAC?

Part of the reason may be women's fears of the possibility of a long, protracted delivery that ends in surgery. Another possible reason is that not all women have access to facilities that are prepared to handle VBACs.

If you and your health care provider think that VBAC is right for you, don't be afraid to try it. Although it's impossible to predict if a VBAC will be successful, you can increase your chances of a positive experience. Try these ideas:

• Discuss your fears and expectations of an attempt at VBAC with your health care provider. He or she can help you better understand the process and how you may be affected. If you have doubts about your health care provider, you may wish to find another whom you find easier to trust and rely on. Make sure your current health care provider has your complete medical history, including records of your initial Caesarean birth.

• Take a class on VBAC, with your labor coach, if possible. These classes often help you work through concerns you may have about VBAC.

• Plan to have your VBAC at a well-equipped hospital. Look for one that has continuous fetal monitoring, a surgical team that can be assembled quickly and the ability to administer anesthetics and blood transfusions 24 hours a day.

• Try to avoid the use of drugs to induce labor, especially if the cervix is tightly closed and not ready for labor. These drugs can make contractions stronger and more frequent and may contribute to the risk of uterine rupture.

• Make sure your health care provider will be available to you throughout labor. Constant monitoring by your health care provider can decrease the risk of complications.

• Think of yourself as an athlete preparing for an event. Positive thinking, a healthy diet, regular exercise and plenty of rest will help you give your best shot at labor and delivery.

• Keep your ultimate goal in mind. You want a healthy baby and mom, regardless of how you get there.

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