VBAC Success
What is the most important factor in having a successful VBAC or TOLAC ?
In my opinion, a supportive provider is the most important. Your provider can really make or break your experience, especially when we’re talking TOLACs & VBACs (vaginal delivery after cesarean). If your provider isn’t on board with a TOLAC (trial of labor after cesarean), then you're constantly in conflict between what you want for your birth and what your provider is comfortable signing off on. To complicate matters, some women find that initially their provider is supportive until late in the pregnancy when the script is flipped. If you find yourself in this position, reach out and we can talk options. There’s almost always a Plan B.
When possible, I always recommend midwifery care. I know that isn’t always an option for everyone, but the data backs up my feelings on this one. If you are apprehensive about the thought of an out-of-hospital birth, look for a CNM that delivers in a hospital setting. Texas Health Resources nurse midwives and Midwife + Co. both deliver at Texas Health Harris. The midwives at Allen Birthing & Wellness deliver at Medical City McKinney in addition to the birth center. This really gives you the best of both worlds for midwifery care and the security of birthing in a hospital setting.
Ok, so a provider that isn’t in conflict with your birth plan is super important, maybe the most important, but it’s only the first half of the issue. The other important part here is staying low intervention through delivery. Women who experience spontaneous labor have a higher VBAC success rate and lower risk of uterine rupture. So, when attempting a TOLAC, you ideally want labor to start spontaneously and you want labor to progress. There’s conflicting studies on epidurals , but just generally speaking, chances of vaginal delivery are much higher without intervention. And we have studies that give us the facts on how we can increase chances of spontaneous labor as well as progressing in labor and not stalling. So, once your provider is on-board for your TOLAC, a plan needs to be in place for avoiding interventions in your labor. Those two together, a supportive provider and a low intervention birth plan, will increase your chances of a successful VBAC.