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Thread: Vbac

  1. #1

    Vbac

    I had two C-sections but would like to try a vaginal birth for our third child. The doctor said I did not dilate enough after over 12 hours of labor. Did I just need more time? Or is a vaginal birth just not an option at this point?

  2. #2
    Dear amanti007,

    Thank you for posting this interesting question.

    In labour it is really important that a woman is left as undisturbed as possible and is able to 'go within herself' - turning off the conscious side of her brain and trusting in her body and her baby. Countless studies and years of experience have shown that when a woman is in this sort of environment and she feels safe in her surroundings her body will naturally know what to do and the contractions will work efficiently to smoothly open the cervix.

    If a woman feels disturbed, watched, unnecessarily touched etc then her body will tense up when the contractions come and resist them - making them more likely to be perceived as painful and labour to be more likely to last longer. What environment were you in when you gave birth? Were you given respect and privacy? These are absolutely essential for labour to progress in a normal manner. In particular, induction (of any kind) often leads to 'failure to progress' as the natural hormones are not present and a woman is often too confined by being monitored. Of course there are some cases where medical induction is necessary (and it is possible to have a positive birth experience with induction) but all too often women are induced to meet schedules or non-individually tailored guidelines.

    The average length of a woman's first labour is 12 hours. This refers to active labour which is when a woman is in established labour (rather than early labour when she is just starting to dilate). When you talk about 12 hours are you talking about the total labour length or the active labour length. Do you know at what dilation you reached? 12 hours is not considered an unusually long labour.

    The problem with quantifying how a labour is progressing based solely on internal examinations (ie. the dilation of the cervix) is that every woman dilates differently. If a woman is managing well and there are no other concerns then she could be in labour for 2-3 days; many women have a long early stage of labour. Internal examinations themselves can unfortunately cause the body to clamp up and stop responding smoothly to the contractions as they hinder a woman's ability to go within herself in labour. If a woman feels fearful in labour then labour is far more likely to stall.

    Choosing a midwife to manage your care makes it far more likely that you will have a natural birth.

    You still have a good chance of having a VBAC after 2 c-sections; the likely success rate of having a VBAC in this case is 75%. As you know, there are many risks associated with having a c-section and although there is a risk of uterine scar rupture with a VBAC this risk is small (less than 0.5%) and you would be carefully monitored in labour to check for this starting to occur. Having a supportive midwife/doctor is really important when you are thinking about a VBAC.

    Please do post back with any further questions you have on this interesting and important topic.
    Warm wishes,
    LJ

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