I am also hoping/preparing for a VBAC.
I'm reading VBAC Companion (Henci Goer) and Ina May's Guide to Childbirth (Gaskin). Also The Thinking Woman's Guide to a Better Birth (can't remembe the author - but in addition to being a great overall labor/delivery book, it also has terrific VBAC info).
My OB is totally for it. I had a c-sec at 32 weeks for my twins. Actually dd was born vaginally and then ds became transverse (sideways) after she was born and we couldn't get him to move -- plus it was 32 weeks and no one wanted to mess around with a premature Baby B (Baby B's frequenty have more problems than Baby A's due to placental abruption), so out he came. I think because of this reason, I've never had any regrets or negative feelings at all about my c-sec.
Good news for VBAC this time:
*Dilated to 10cm naturally on my own (in spite of toxic doses of mag sulfate to stop labor, no less) and delivered dd with no problems (of course, she was 4 lbs. so not exactly a huge test there, but anyway!)
* Low transverse incision
* Double-layer suture
* Supportive OB
* Supportive dh
Bad news for VBAC:
* History of preterm labor. I was on bedrest from 28 weeks with twins and delivered at 32 weeks despite aggressive meds to stop labor. Now on the one hand, I delivered 8.5 lbs of baby so I *should* be able to get to term this time. But on the other hand, preterm labor is preterm labor, and it means I may be monitored a bit more toward the end (which introduces greater likelihood for c-sec for a number of reasons). Plus, if I do have problems with preterm labor again and the baby is "in distress", the tocolytics (terbutaline, etc. to stop labor) used may mean my labor has to be induced which again increases chance of c-sec. I'm still researching this very specific aspect, but currently this is one for the negative column.
* Very bad adhesions from previous abdominal surgery (and now, no doubt also from my c-sec) increases chance of uterine and/or bladder rupture.
: So my actual risk of rupture might be toward the higher end of the .5-3% risk often quoted (depending on the study).
All in all, I've decided based on everything I've read thus far, that the best and safest choice for us is to:
* Birth in a hospital capable of doing a c-sec within 20 minutes MAX of rupture
* Plan for drug-free birth
* Plan for intervention-free birth, except:
* Allow EFM (e.g., via Doppler) to look for signs of rupture.
Fortunately, I have a very supportive OB, and I am also currently looking for a labor doula.
Ultimately, I'm doing everything I can to have a safe VBAC, but I also know from my last pregnancy that you can never plan every little thing, and if a c-section is warranted then I will have one with zero regrets again, knowing it was done because it was needed. I know from experience that there can be worse things in life than not having the delivery of your dreams.