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What increases odds for VBAC?

post #1 of 9
Thread Starter 
Obviously choice of provider would be number one but what else do midwives/hospitals look at when evaluating a VBAC candidate? I know they look at the length of time between the initial c-section and VBAC and 18 months is the supposed minimum. Although I've read some women are told 2 years.

What about weight? I'm probably about 20 pounds overweight. I'm not sure of my BMI. Should I try to lose weight before I get PG to increase my VBAC chances? What about overall fitness? I'm not in great shape because I'm a working mom and have no time to work out.
post #2 of 9
According to a study from the NICHD (they developed a predictor for VBAC success), the following things are positively associated with VBAC success:

-younger maternal age
-lower BMI
-white, non-hispanic race
-hx of previous vaginal delivery
-non-recurrent reason for C-section

Using their nomogram, an 40-year old african american woman with no history of vaginal birth, bmi of 27 (overweight but not obese) and a non-recurring indication for c-section (i.e. last baby was breech, but this one is not) has an approximately 45% probability of a successful VBAC. A 25-year old white woman with a bmi of 23 and with the same medical history has approximately 80-85% probability of successful VBAC.

(from Grobman et al., Development of a Nomogram for Prediction of VBAC, Obstetrics and Gynecology vol. 109, no. 4 April 2007)

keep in mind, however, as is often repeated on here, that YOUR pregnancy is not a statistic.

It certainly would benefit you, and a future pregnancy, to lose a bit of weight and adopt a healthier lifestyle/eating habits. However, 20 lbs is probably not going to make or break your VBAC.
post #3 of 9
Absolutely not a statistic...
If I were preparing to attempt a VBAC again, here are the steps I would take:
-continue eating a traditional foods diet (I have lost 100 pounds since DD2 was born)
-cut coffee
-continue yoga and walk more often or swim for exercise (I do yoga 5 days a week)
-drink Red Raspberry Leaf tea after my first trimester, and more during my third
-I would take evening primrose oil orally starting at 6 months and begin inserting vaginally at 37 weeks
-I would not allow myself to go over 40 weeks pregnant (I make large babies. It's in the genes. I think my chances would be better if my next didn't weigh 11lbs. )
-I would make sure I did pelvic rocks daily and other exercises to encourage correct positioning.
-choose homebirth (or be very very careful with the practitioner I choose)

Now, that is just for me. Goals could and should be different for you. Here are some general tips on VBAC:
-lower abdominal horizontal incision scar
-do not accept induction
-labor naturally
-choose midwifery care or homebirth
-have a doula
-take a childbirth course

HTH!
post #4 of 9
The one thing that helps increase your chances for a successful VBAC would be to avoid if possible the reasons for the first c/sec, such as induction and augmented labor drugs.

Also, try not to have a epidural. It can slow labor and dilitation and cause fetal distress (late decels) and necessitate another c/sec. An epidural can be a lifesaver for a long labor, but it has its dark side also.
post #5 of 9
Knowledge.

Staying active during pregnancy (walking, yoga, stairs, etc.), a good diet, going into labor naturally, staying upright during, no pain relief, and MW assisted homebirth. Just off the top of my head...
post #6 of 9
things that make a good vbac candidate :

- at least one year (preferably two) between pregnancies
- bikini cut incision
- double suture closure
- healthy mama (mind and body)
- having already had a vbac (but of course there has to be the first one but it does increase the chances of having one if you already have,\)
post #7 of 9
What is primrose oil and what can that do to help?
post #8 of 9
Quote:
Originally Posted by mamafever View Post
What is primrose oil and what can that do to help?
Evening Primrose Oil (also known as EPO)....it's a supplement that's usually found in capsules....it can help to soften the cervix and prepare the body for labor. I'm sure there's more, but that's the basics I remember!

mrsfru
post #9 of 9
confidence in yourself and feeling like your provider is confident in you
self awareness of your own body
walking as much as possible
staying active
staying positive
going into labor on your own
no pain drugs
patience
timing and luck
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