Vaginal Birth After Cesarean (VBAC)

It hit me just how long it has been since I have kept up-to-date with posting in this blog. I do apologize! I am still in practice in Southern Utah, and my clients keep me busy! 

We just wrapped up Cesarean Awareness Month last week. In case you don't follow me on Facebook, here are my posts to bring about awareness regarding both cesarean section and vaginal birth after cesarean: 

Did you know that approximately 1 in every 3 women in America who walk into the hospital to give birth, walk out healing from major abdominal surgery?

Did you know that a cesarean for "big baby" is actually not a valid medical reason, and is advised against by the American College of Obstetrics and Gynecology, based on empirical research?
Did you know that according to research, most complications during labor that lead to a cesarean are iatrogenic (physician or procedure caused)? This includes cord prolapse, cesarean for nuchal cord (cord around the neck), fetal distress, hemorrhage, and more

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Did you know that not only is Vaginal Birth After Cesarean (VBAC) possible, but that it's statistically low risk? The main concern with a VBAC is uterine rupture, which has a likelihood of 0.3-0.7%. This means that you are 99.3-99.7% likely to NOT rupture.
Being in a birth setting which is conducive to complete support and facilitation of VBAC is the most important aspect, beyond researching the ins and outs of it all. Unfortunately, many care providers and hospitals have policies and procedures which reduce your likelihood of a successful VBAC. Not because it can't be done, but because of the "rules" that often come with VBAC. Sadly, many care providers are not up to date with research in this area, and have restrictive rules surrounding VBAC labor.

Did you know that a VBAC after more than one cesarean is not only possible, but still considered relatively low risk? I have attended women who have had 2 cesareans, and have a current client who has had 3.
The largest research conducted on vaginal birth after multiple cesareans showed a uterine rupture rate of between 1-1.7%. The American College of Obstetrics and Gynecology position statement on VBAMC say that women who have had 2 cesareans with low-transverse incisions should not be discouraged from planning a vaginal birth.

Did you know that your chances for a successful VBAC lie with the rules your care provider might have for VBAC labor/birth, rather than your inherent ability to give birth vaginally?
Restrictive (and non-evidence based) rules such as scoring "well" on a trial of labor success scoresheet (where they take into consideration your age, weight, reason for previous cesarean, whether you've had a vaginal birth, etc), going into labor prior to 40 weeks, needing to dilate at the rateof approximately 1cm per hour, consistent monitoring, epidural (some require this), and the type of closure you had during your last cesarean.The American College of Obstetrics and Gynecology does not limit their recommendations for encouraging VBAC in women with 1-2 prior cesareans to these things, yet Obstetricians and Midwives (even home birth midwives!) restrict to these things. Make sure you know your care provider's beliefs about VBAC, and what rules they may have in labor and birth. How do they feel about VBAC? Are they hesitant, worried, even afraid? Do they know what the research says about VBAC risk and benefit? Find someone who knows these things thoroughly, and who is experienced and comfortable with VBAC.

Did you know that not being dilated or effaced by your due date is NOT an indication that you are not likely to have a successful VBAC? Though this is often said as a stipulation to "allow" (gotta stop allowing people to "allow" you in birth, ladies!) you to have a trial of labor, it is not evidence based. Dilation only tells you what your cervix is doing at that moment. That's it. Normal gestation length (38-42 weeks) applies to VBAC moms as well, and some may need longer.
Waiting does not increase your risk of rupture.

Christine Fiscer is a Traditional Midwife in Southern Utah who has been entrenched in VBAC research for over ten years. She has been attending VBAC and VBAmC (vaginal birth after multiple cesareans) at home for eight years. 

FREE Waterbirth Information Night

*~*Join us for a FREE Waterbirth Information Night on
Saturday, April 30th from 5-9pm in St. George!*~*



Have you ever wondered about the science behind giving birth in water? Have you heard myths about baby not being able to breathe, or gravity not helping in water?
Come with any and all questions!

Free food, giveaways, information packets and more ...

Visit the Events page for more information. Hope to see you there!

Find additional information and RSVP on our Facebook Event Page

Date: Saturday, April 30th
Time: 5:00-9:00pm
Location: Sage Hills Yoga Studio in St. George
Cost: FREE

New Reason to Birth At Home : H1N1

Because of the H1N1 scare, Hospitals in Southern Utah are limiting visitors to only *2* pre-designated visitors for the entire duration of a patient's stay. This means that if you have older children, they will not be allowed to visit mom, or see their new sibling until mom goes home. Other members of the family will also not be allowed to visit, unless they are one of the two people allowed when mom was admitted.

This is from Dixie Regional Medical Center:

With the emergence of H1N1 cases earlier this year infection control professionals are anticipating a busy flu season. To keep the hospital as safe as possible for patients, Dixie Regional asks that all visitors be at least 15 years old. Children ages 14 and under frequently transmit viruses. Because the risk of H1N1 is higher for pregnant women and youth, on the 400 East Campus (where
women’s and children’s services are based) patients are also asked to designate two visitors for the length of their stay.
We have not seen a marked increase in flu cases yet, but believe it is wise to be proactive about potential spread of illness. Thank you for your support as we balance the desire for visitors to see loved patients with patient safety concerns. Further visitation restrictions may be implemented this fall or winter, if there is a significant increase in the number of patients being hospitalized with influenza. For more information about influenza or the most current updates on H1N1, please visit the Southwest Utah Public Health Department website: www.swuhealth.org. For more information about visitation at Dixie Regional, please call 251.2108.

When you birth at home, not only is the risk to baby and mom GREATLY reduced of contracting an illness ( common when visiting hospitals, after all, they *are* full of sick people! ), but mom is also allowed to have as many or as few people as she wishes to be present for her birth. Family centered birth is very important for families to grow and bond together. Don't cut your children or other loved ones out of your birth plan because of the flu season. Birth at home. :)

Birth Services in Southern Utah

Have you ever been curious about home birth? Have you had those "what if..." questions?

Have you ever been curious about waterbirth?

Have you had a cesarean, and were told you have to have another?

A great thing to do, is to ask questions, and interview multiple care providers. I offer free initial consultations, in which you can ( and are encouraged to! ) ask any and all questions you can think of. And the great part is, there is no obligation to hire me as your Midwife. Sometimes the first step is being able to ask all of the questions you are curious about. Like, what happens if an emergency arises?

Home Birth is a safe, healthy alternative for low risk women who want to birth on their terms and in their own environment. For reasons why home birth is safe and a great option, read the last post ( 10 Reasons to Birth at Home )

If you'd like to check out the services that I offer, you can go here: Joyful Birth Services

And to schedule a free initial consultation, email me at JoyfulBirthServices@gmail.com, or call 435-216-5411