Help me understand why VBAC is such a big deal..

M OB told me today that he doesn't do VBAC's because he would have to shut down his office and basically wait at the hospital until the patient delivers but he does vaginal births all the time so what is the difference....is it just because of the risk of uterine rupture?? He said if i wanted a VBAC he would have to refer me to another office but i really want my OB to deliver me....(i have placenta previa so i might not have a choice but am curious about the difference...)

Re: Help me understand why VBAC is such a big deal..

Ugh...VBACS and doctors. Yes, sometimes there are qualifying reasons why you wouldn't be a good candidate. But sometimes, you just ended up with a c/s the first time, and now they want to push for another.


Here is how they explained why they are so scared to do it at my office:

IF something WERE to go wrong during a VBAC (which is a very small risk), it's never a small issue . I was told it is "catastrophic."

That's not to say you will automatically die during a uterine rupture... in fact, some women rupture their uterus during their first birth for whatever reason.

Re: Help me understand why VBAC is such a big deal..

Yes, I think it's due to the risk of your uterus rupturing because of the scar tissue after the c-section. A uterine rupture is rare but very serious and so most doctors shy away from it.

Re: Help me understand why VBAC is such a big deal..

I also think that because of the risks there may need to be an OR team ready for you in case of an emergency C. Don't know why his office would have to close down.

ETA: I am not 100% sure that is the case, just what I heard.

Message edited 2/16/2011 2:16:52 PM.

Re: Help me understand why VBAC is such a big deal..

From my search for a dr who would do a VBAC, it seems to be more of an insurance reason. There are lots of doctors whose insurances do not cover VBAC. Its based on old data that is really no longer relevant.

The hospital where I'm delivering allows VBACs but there has to be a doctor present in case of rupture. If there is a rupture, then surgery would be needed immediately. However the chances of rupture are less than 1% as long as you are a good candidate. Its the same chance a woman who did not have a previous c-sec would have of uterine rupture.

Re: Help me understand why VBAC is such a big deal..

Well if he is a solo practice and he has to be at the hospital the whole time, then I can see why his practice would close. But if he is delivering anyway, I would think he would have to be there for labor checks anyway?

I'm on the fence about VBAC, at first I was all for it but the more I think about it the more nervous I get. You have a greater chance of rupture after having a c/s because there is a weak spot on your uterus... it's still a small percent but if it does happen you could die or the baby could die or have some kind of brain injury if they aren't able to get it out soon enough. There are a million things that can go wrong during labor AND during a c/s, but this one freaks me out.

Re: Help me understand why VBAC is such a big deal..

Not that this answers your question - but when I speaking to a nurse once she told me that when she was trying to decide which area of the hospital she preferred to work in - she worked in the maternity ward for a short period of time. She said a woman chose to have a VBAC and while she was pushing, the baby basically got choked by the scar tissue from her c-section and died. I would never even have thought that was possible!

Re: Help me understand why VBAC is such a big deal..

Re: Help me understand why VBAC is such a big deal..

My OB was up for it as long as the baby didn't "measure" more than 7 pounds and it was at least a week early.


OBs pay the one of the highest malpractice insurance rates. I'm sure that plays a role in their decision.

Re: Help me understand why VBAC is such a big deal..

That doesn't make any sense to me. My OB, who was pro-VBAC, was barely there while I was in labor. Most of the time he was delivering other women via c-section. The nurses are there to monitor you and the on-call OB was the one who ended up delivering me - it's not like these hospitals have ONE OB. However, if you're at a solo practice, then I can sort of see why he is concerned - he will have to leave the office as soon as you go into labor to go to the hospital because he's so concerned with the possibility of a uterine rupture.

If it were me I'd be finding a new OB because I wouldn't want to wait till week 25 to find a new one if the previa resolved itself.

Re: Help me understand why VBAC is such a big deal..

Message edited 2/17/2011 9:37:37 AM.