Posted: Sep 12, 2012 9:00 AM
Vaginal births after C-sections were all the rage in the '90s, but have tapered off. Here’s why one mom chose to go the VBAC route… not once, but three times.

My first pregnancy, in 1995, ended in a C-section. I was young and single, had the support of my parents and at the time, wasn't terribly concerned that my delivery was a surgical one. My baby was born -- he was so warm in that distressingly cold operating room -- and I loved him from the get-go. My recovery was difficult, after all, it is major surgery and the incision isn't a tiny one. I had no trouble establishing breastfeeding and aside from a lingering numbness (seriously, will this ever go away, after nearly 17 years?) suffered no long-term side effects.

The VBAC idea

When I got pregnant with my second child in 1999, I took myself and my new husband to the obstetrician's office, expecting to be told to anticipate a repeat C-section. I was surprised and kind of angry when he strongly recommended attempting a vaginal birth. I thought it was a crazy idea and a bad one to boot. I had heard the adage, "Once a C-section, always a C-section," and ascribed to it completely.

However, I had many months to consider the decision, and decided to go ahead with a VBAC (vaginal birth after cesarean) trial. I went into labor five days after my due date and welcomed my second son with a happy heart. My labor was quick and uneventful (around 11-1/2 hours total) but I tore like crazy, thanks to a mismanaged pushing stage and a big baby. My recovery was just as bad as my C-section recovery, if not worse.

Baby number three

When I got pregnant with my third, I knew I was going to VBAC it again, even though my last birth hadn't had the quick recovery I had hoped for. My obstetrician, this time, was more ambivalent about VBACs, as the tide had turned in his profession (from the outright encouragement of the '90s) to: "Hey, maybe this isn't such a good idea," in the next decade. More doctors were hesitant to recommend VBACs due to what I believe was a fear of malpractice lawsuits, in the event of a failure that resulted in uterine rupture. Uterine ruptures are a catastrophic complication that can end in the death of baby or mother.

A recent study found an overall incidence of pregnancy-related uterine rupture of 1 per 1,416 pregnancies. This includes rupture of an unscarred uterus, as well as those who had a scar from a C-section or other surgical procedure.

However, the rates for uterine rupture are low. A recent study found an overall incidence of pregnancy-related uterine rupture of 1 per 1,416 pregnancies (which translates to 0.07 percent). This includes rupture of an unscarred uterus, as well as those who had a scar from a C-section or other surgical procedure. According to, "Medical experts state that the risk of a uterine rupture with one prior low-horizontal incision is not higher than any other unforeseen complication that can occur in labor such as fetal distress, maternal hemorrhage from a premature separation of the placenta or a prolapsed umbilical cord."

I decided on a trial of labor, and this one went very quickly -- she was born less than six hours after my contractions got regular. And it was amazing. This was what I thought birth should be like. Her exit from my body was surreal. I felt an absurd, instantaneous and overwhelming joy when I saw her for the first time. I experienced little trauma and had a quick and amazing recovery -- the goal I was searching for when I had agreed to my first VBAC nearly four years prior.

Baby four

I never considered a C-section with my fourth pregnancy, even though my OB yet again told me I had the choice. He said that studies haven't shown whether a third VBAC would further test a prior C-section scar or that it meant that I had healed very well. But I knew that the hospital I delivered at had a full-time operating room on standby and an on-call anesthesiologist, in case an emergency would arise.

Her birth took a bit longer but was no less magical than my third. She was born during a blizzard on Christmas Eve and everything was simply incredible. I was able to hold her right away and I was in awe from the moment she was born. Recovery was awesome and I was full of energy and was so happy I was able to, yet again, have a vaginal birth.

The decision to VBAC or not isn't an easy one. Complications from C-sections aren't unheard of and may even be more common than complications from a VBAC, but many moms feel safer with a scheduled surgical delivery. I'm so glad, however, that my second baby was born in the '90s when VBACs were strongly encouraged. I'm honestly not sure I would have considered one otherwise.

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