Expert: Dorothy H, LCCE - 1/14/2010

Question
I fractured my pelvis 14 years ago, when I was 16, in a car accident.  I had three non-displaced fractures.  I healed quickly and without complications.  I had my first baby almost 2 years ago via c-section.  I dilated to 9 cm, on pitocin and forced to be in bed on my back, but my daughter never passed 0 station and I never felt the urge to push.  I really want to try a VBAC.  I understand the risks of a VBAC vs. repeat c-section and understand that my chances of success are lower.  Is there anything I can do to increase my chances of success? Thanks!

Answer
Hi Jenni,

There are definitely some things you can do to increase your chance of a successful VBAC!

First of all, there is a good chance that the reason you wound up with a cesarean had more to do with the induction (Induction increases the chance of cesarean birth tremendously) than with your previous fractures.  It may have been a matter of your body working a little TOO well (in other words, your body may not have been ready to give birth and therefore that's why the induction didn't work)

To increase your chance of a successful VBAC, the most important thing is to find a care provider who supports VBACs.  Find out their VBAC success rate. Go to your local ICAN chapter and get the names of VBAC-friendly care providers.  A midwife might be a good option as well; many midwives have great VBAC success rates, and generally they won't be keeping you in bed on your back ,but encouraging you to move during your labor.  Whether you use an OB or midwife, make sure that they are truly supportive and will give you your best chance of a successful VBAC.

Also, consider hiring a doula. A doula can help you get into positions during labor that will help your baby move down, help keep you comfortable, etc. plus she may have worked with VBAC couples in the past, and may be a good resource for you as well.

Read!  Getting some good birth stories into your head can help you develop a positive attitude, which can be very important.

Join a support group -  if there is an ICAN chapter in your area, consider joining.

Consider declining ultrasounds late in pregnancy - the size of a baby using ultrasound can be off by more than a pound or more, but some doctors will estimate a large weight size and scare you into a repeat cesarean that might not be necessary.

As a doula, I have seen many women with similar stories to yours go on to have successful VBACS.  :)

I wish you the best with any subsequent pregnancies you might have!

Sincerely,

Dorothy Haines, LCCE