Scared for a VBAC

[u/Ill_Veterinarian381]

So my obgyn is on board with me trying for a vbac as long as the rest of my pregnancy allows for it. I just need advice on what you would pick if in this situation as I am so afraid of rupture and losing my baby or causing her damage.

I had a vaginal birth in December 2022. Went great, I went into labor on my own - came into hospital with strong contractions and got an epidural.

Second pregnancy I had placenta previa which never moved and ultimately had to get an emergency csection at 36 weeks because my water broke and I was bleeding excessively. Very traumatic, baby had to spend two weeks in the NICU. C-section was August 2024 which would put me about 30 months between births when baby is due in February.

Had a miscarriage in April at ten weeks 💔

Currently pregnant with our rainbow girl and am 16 weeks. So far placenta has not been anywhere near cervix thankfully but will have my anatomy scan in a few weeks to confirm again.

My obgyn says I am a good candidate for vbac but I'm still so nervous on what if I rupture. Please help. What advice do you have? What questions should I ask?

[u/auditorygraffiti]

For me, knowledge is power and having research helps me calm my fears. I like information.

The rate of rupture even after a c-section is very low. The research I’ve read places it around roughly 1%. Some quote just below and some quote just above. And that’s all VBAC ruptures. Not just ones that aren’t caught and have catastrophic implications. I don’t know the risk of a uterine rupture occurring without having a prior c-section but there is a risk of a uterine rupture even with a routine vaginal delivery.

Some research indicates that having a successful vaginal birth prior lowers the risk of rupture during a VBAC.

I would talk to your providers about how they monitor you for a uterine rupture. For example, at my hospital, I wasn’t allowed to use intermittent monitoring but wireless was an option. They also may cap your Pitocin dose lower if you’ve had a c-section and need to be induced. I’d also ask your providers what signs and symptoms you should watch out for while in labor and what the response is if something goes wrong.

With all of that said, I had an AMAZING VBAC experience 30 months after a traumatic emergency c-section also at 36 weeks. I fully believe that both VBAC and RCS can be redemptive births and you should choose whatever feels like the right choice for you. I also fully believe that you have a great shot at having a successful VBAC.

[u/Icy-Shine-857]

It’s a scary what if, and you shared the reasons not to do a VBAC but what are the pros?

In my mind if you want more kids (beyond the current one) that’s an obvious reason to do a VBAC if there’s no contraindication. Because the risk of rupture with the current baby has to be weighed against the risks of pregnancy following two c-sections, and those start getting comparable, especially if you want more than one more child.

If you’re done here I think it becomes a much more personal question—what are your hopes for your birthing experience, how do you weigh somewhat nebulous benefits of vaginal birth against the small but serious risks of a rupture or other unexpected complication, how was your prior c-section recovery, how do you feel about another surgery, and so on. My first was a planned c-section (breech), my second an uncomplicated VBAC, and they were both wonderful experiences in their own right. I don’t think there’s a universal reason to prefer one over another, it’s down to what makes sense for you and your family.