Being Denied a Vaginal Birth After Cesarean (VBAC)

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Doctors and scientists continue to study the risks of a trial of labor after cesarean (TOLAC) over an elective repeat cesarean (ERCS). However, vaginal birth after c-section (VBAC) has been shown to be safe for most women, with a few exceptions.

If you would like to attempt a VBAC, but your doctor and/or hospital is not willing, the following strategies may help.

Know Your Medical History

Get copies of your original surgical reports. Find out what type of incision was made on your uterus, which may be different than the scar on your abdomen. Find out what type of closure was done, double or single layer repair. Find out the reasons given for your original cesarean. These will be key points in your search for a vaginal birth.

Do Your Research

Know what the risks are of an elective repeat cesarean as well as a VBAC. Know what the signs are of uterine rupture and what you can do to avoid it.

Get Support

There are other women and men out there working on VBAC rights. Find support from these people and learn what they've done to further their cause. Look up the International Cesarean Awareness Network (ICAN). ICAN can provide you with morale and physical support. If there is no chapter in your area, find out how you can start one.

Talk With Your Doctor or Midwife

What is their policy on VBAC? If they do not allow it, find out why. Do they feel that you have a medical reason why VBAC is not a good idea? Are they simply against VBACs? Or perhaps they have an insurance policy that says they should not do VBACs.

If your doctor or midwife cannot do a VBAC for legal or insurance reasons, you have a decision to make. You can stay with this practice and have an elective repeat cesarean, or you can look for a VBAC-friendly practice.

Check Hospital Policy

If the hospital where you plan to deliver has a no VBAC rule, what happens if you come in and refuse surgery? Are there exceptions made to the policy? If yes, how can you get one? If no, is there another hospital where you could give birth?

If not, you can consider temporarily moving closer to a hospital that allows VBACs,, even if this means staying in a hotel. Some parents choose to have alternative births, such as a home birth. These are not options for everyone. Talk to your health care providers about your specific situation.

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  1. Rezai S, Labine M, Gottimukkula S, et al. Trial of labor after cesarean (TOLAC) for vaginal birth after previous cesarean section (VBAC) versus repeat cesarean section; a review. OGIJ. 2016;4(6). doi:10.15406/ogij.2016.04.00135