More on VBACs...
According to the American College of Obstetricians and Gynecologists, you’re a good candidate for a vaginal birth after a c-section if you meet all of the following criteria:
- Your previous cesarean incision was a low-transverse uterine incision rather than a vertical incision in your upper uterus (known as a “classical” incision) or T-shaped, which would put you at higher risk for uterine rupture.
- You’ve never had any other extensive uterine surgery, such as a myomectomy to remove fibroids.
- You’ve never had a uterine rupture.
- You have no medical condition or obstetric problem (such as a placenta previa or a large fibroid) that would make a vaginal delivery risky.
- There’s an obstetrician on site who can perform an emergency c-section if necessary.
- There’s an anesthesiologist, other medical personnel, and equipment available around-the-clock to handle an emergency situation for you or your baby.
Factors that would work against you having a successful VBAC include:
- Being an older mom
- Having a short time between pregnancies (18 months or less
- Having your pregnancy go beyond 40 weeks of gestation
- Having a baby with a high birth weight (over 4,000 grams, about 8.8 pounds)
- Having a high body mass index (BMI)
PROTOCOLS FOR A TOLAC/VBAC
To provide the safest care possible for women undertaking a TOLAC, we strictly adhere to the following guidelines set up by Einstein Montgomery. They have been formulated to ensure the best possible outcome for you and your baby, and put a priority on safety in case of an emergency, such as a uterine rupture. PLEASE NOTE: We can only accept patients who understand and agree to these protocols.
- Upon arriving at the hospital in labor, you will have an IV heplock inserted. This will not be connected to IV tubing and an IV bag unless necessary.
- The “deadline” for delivery is 41 weeks. We will check your cervis at 40 weeks — if your cervix is ripe, an induction will be offered at 41 weeks. If your cervix is unripe, a repeat c-section will be scheduled at 41 weeks.
- You will have continuous fetal monitoring during labor, while still being able to get out of bed, stand up, sit on the birth ball and use the squat bar (we have mobile monitoring).