More VBACs



Have you heard the amazing story of the mom who gave birth in the car last week to unexpected breach twins? It was a VBAC. You just can’t help but marvel at birth: a breach VBAC of two babies on the way to the hospital because they came so fast. You tell me. Does that give you confidence in VBAC or what?




We should have confidence in VBAC. The medical establishment maintains control by giving permission to women for a trial of labor, thereby eroding their confidence in their own autonomy. Policies by the American College of Obstetricians and Gynecologists (ACOG) limit access to VBAC and scare tactics terrify women into believing that VBAC is dangerous when it is not. It is the procedures and drugs associated with hospital childbirth in the US that make birth unsafe. An increase in VBACs would, in fact, increase the safety of birth. 


When I was a member of the New Mexico Midwifery Advisory Board in the eighties, I researched the risk of VBACS and found their risk to be comparable to the risk of rare possibilities that we do not routinely dwell on or prepare for: placenta abruption, cord prolapse or shoulder dystocia are all more common than uterine rupture.




Our US VBAC rate has dropped from a high of 28.3% in 1996 to 10% today. Look at the chart above, reprinted on Childbirth Connection from the US National Center for Health Statistics, to see how parallel the rise in cesarean rate is with the drop in VBAC rate. The 28% VBAC rate from the past was the result of childbirth advocacy ignited by the publication of Nancy Wainer”s book, Silent Knife, which first articulated this connection between VBAC increases and cesarean decreases. Evidence suggests that a 75% VBAC rate is normal.


This current VBAC drop is directly related to the identification of VBAC as high-risk by the ACOG in 1999, thereby requiring an anesthesiologist, an obstetrician, and an operating room on stand-by. As a result, many hospitials that could not provide these services effectively banned VBACS and no longer “offer” them.



VBAC is the ultimate mind game. How do you get the confidence to believe in birth again after you have been disappointed? How do you believe in your body again? How do you believe in yourself? Surround yourself with others who have already braved the waters. Find birth attendants who absolutely believe in you. Only share your birth plans with friends who will totally support you.




The International Cesarean Awareness Network (ICAN), started in 1982 by Esther Booth Zorn, is the premier resource for VBAC with the Vaginal Birth After Cesarean Checklist, 10-year population based study of Uterine Rupture and many more articles as well as local ICAN chapters nationally and internationally, webinars and online forums.


Childbirth Connection, formerly The Maternity Center, is one of the oldest and best resources out there on any topic related to maternity care. Check out their VBAC or Repeat C-Section: What You Need to Know. 


Nicette Jukelevics, childbirth educator and author of Understanding the Dangers of Cesarean Birth, has, an evidence based resource.


Read Midwife Thinking’s great blog, VBAC: making a mountain out of a mole hill.


Join the VBAC conversation on Ask a question, search the archives, find support.


Above all, trust yourself and you will know what to do.


Peggy O’Mara  (101 Posts)Peggy O’Mara founded in 1995 and is currently its editor-in chief. She was the editor and publisher of Mothering Magazine from 1980 to 2011. The author of Having a Baby Naturally; Natural Family Living; The Way Back Home; and A Quiet Place, Peggy has lectured and conducted workshops at Omega Institute, Esalen, La Leche League International, and Bioneers. She is the mother of four.


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