Weighing the Risks
Having a VBAC increases a woman's risk of complications, including uterine rupture, endometritis (a temporary inflammation or irritation of the uterine lining), and a variety of newborn injuries caused by the uterine rupture. The good news is that these complications are relatively rare. In fact, past research from Ohio State University Medical Center (the largest study ever done on the safety of VBAC) found that the current risk of developing a serious complication during a VBAC is about 1 in 2,000.
However, keep in mind that not every VBAC attempt is successful. Kate Kelly, mom to three boys in Pelham, New York, tried a VBAC with her second child. "Nothing bad happened -- it was just a replay of the first birth," she says. "I dilated quickly, contractions were strong, and everything was great until it was time to push. Only this time, there was a frame of reference, so when my doctor said, 'This just isn't going to happen,' I was like, 'Fine.'"
Of course, you have to be prepared for the fact that if you can't follow through with the VBAC, like Kelly, you'll have to endure the painful recovery that follows a c-section -- after you just withstood hours of labor. In addition, a failed VBAC attempt leads to a higher risk of a post-operative infection compared with the risk for women who deliver by scheduled cesarean, says Dr. Hoskins. For many expectant moms, these negative aspects are enough reason to opt for a scheduled cesarean.
On the flip side, repeat c-sections also carry certain risks, such as placenta accreta, in which the placenta adheres abnormally to the uterine wall. And, of course, a c-section involves major abdominal surgery, which makes you susceptible to the associated risks, such as bleeding, infection, or blood clots in your legs or lungs. With a vaginal birth, you'll spend less time in the hospital, and your recovery period will be two weeks as opposed to six weeks or longer.
"I was able to hold my daughter much sooner than I could hold my firstborn, and because I wasn't in a drug-addled haze, I was able to call my family and rejoice in the birth right away," says Eileen Glanton, of Glenside, Pennsylvania. Moreover, this desire to bounce back quickly affects a mom's decision to opt for a VBAC. "I wanted to care for my baby as soon as possible and be able to care for my other two kids as well," says Elain Cox, of Sammamish, Washington.