If you’ve ever had a cesarean section and are pregnant again you may be wondering what your options are for your next pregnancy. Having a
cesarean section for any of your births can cause a lot of moms to wonder if either their body can deliver vaginally or if they even have (or
want) that option.
A c-section is major abdominal surgery and it shouldn’t be overlooked that your body has to recover in a different way than a vaginal birth.
It’s understandable that you may question the feasibility and desire of vaginal delivery for subsequent pregnancies.
It’s understandable that you may question the feasibility and desire of vaginal delivery for subsequent pregnancies.
Most moms can deliver a baby after a cesarean it’s call a VBAC -vaginal birth after cesarean- the process to get there is called a TOLAC or
trial of labor after cesarean. When moms choose a responsible, trustworthy provider and location well equipped to birth with the capability of
performing emergency procedures a woman has the right to attempt a VBAC.
trial of labor after cesarean. When moms choose a responsible, trustworthy provider and location well equipped to birth with the capability of
performing emergency procedures a woman has the right to attempt a VBAC.
There is a caveat and of course the long response to such a heavy consideration REALLY depends on a number of things. I’ll break them
down for you below:
down for you below:
- Why did you have a cesarean in the first place? Just having a C-section doesn’t exclude you or “risk you out” of a TOLAC but an honest
provider will consider your circumstances carefully before flatly denying or accepting your TOLAC request. There are a number of
reasons why you may have had a C-section and just saying “my baby wouldn’t come out” or “my body wouldn’t dilate” are pretty vague
and need further investigation. - Where do you want to deliver? Not all hospitals are able to labor a mother who has had a previous cesarean section. It isn’t that they
don’t want to its that they literally are unsafe for you in case of emergency. They don’t have the resources. Now, if you were to schedule
a C-section that same hospital may be perfectly fine. Why? Resources (i.e. operating room staff) are readily available. - Who do you want as your OB provider? Put another way -are you attempting to deliver with a provider who has a reputation for not
supporting VBAC’s? Or is it someone who is really nice but hasn’t actually attended a VBAC since med school so they aren’t even sure
what to ask or what red flags to be aware of? Have you asked in your community about who has the reputation of supporting successful
TOLAC consents? Why is this important? Your provider plays a huge role in the outcome of your birth. If you stick with someone you
know has plainly refused to TOLAC patient or everyone in your community has beautiful success stories with another provider you can
guess from at least your providers stand point what your outcome may be.
The biggest consideration to make, of course, is what do YOU want. If you’ve never experienced labor contractions before are you prepared
for what they may feel like? This is especially important because your uterus will be contracting on a uterus that has a healed incision scar
and is therefore more at risk for complications. Think about your pain tolerance. Be ready by taking a high quality childbirth class that will teach
you what’s normal in labor and ways to manage that pain. Think about hiring a labor doula. There is research that supports the use of
professionally trained labor support.
for what they may feel like? This is especially important because your uterus will be contracting on a uterus that has a healed incision scar
and is therefore more at risk for complications. Think about your pain tolerance. Be ready by taking a high quality childbirth class that will teach
you what’s normal in labor and ways to manage that pain. Think about hiring a labor doula. There is research that supports the use of
professionally trained labor support.
If you have delivered vaginally before you have the perspective of how to manage the discomfort and length of of that discomfort in labor. Your
choice will have some balance in that regard. But remember, every pregnancy and every labor is different. Again, hiring a doula will help direct
you in finding a rhythm in pain relief. If the cesarean was traumatic in any way having a labor doula can ease fear.
choice will have some balance in that regard. But remember, every pregnancy and every labor is different. Again, hiring a doula will help direct
you in finding a rhythm in pain relief. If the cesarean was traumatic in any way having a labor doula can ease fear.
So have a thoughtful and thorough conversation with yourself, partner and care providers. Be honest with yourself on what you want and
whether its possible to obtain. Remember you can’t plan everything in labor but you can prepare for it.
whether its possible to obtain. Remember you can’t plan everything in labor but you can prepare for it.
Until next time #tranquilpregnancyvibes
Monique Nicole, RN BSN
Pregnancy Wayfinder
