Oklahome BirthNetwork : VBAC in Oklahoma Myths & Facts: Ten Questions to ask your provider about VBAC

VBAC Myths & Facts

Myth #1: VBAC is illegal in Oklahoma.
FACT: VBAC is not illegal in Oklahoma. While many hospitals have policies that discourage VBAC and many physicians and other birth providers have malpractice insurance policies that discourage VBAC, it is not illegal. VBAC services do exist. You can have a Vaginal Birth After Cesarean in Oklahoma! You can VBAC in hospitals, birth centers and at home.

Myth #2: VBAC is dangerous. Repeat cesarean is safer.
FACT: In most cases, VBAC carries less risk than a repeat cesarean. Women give birth safely vaginally after cesarean in Oklahoma, in the United States and around the world. A cesarean carries all the risk of major abdominal surgery (such as infection and possible damage to surrounding organs), the risks of anesthesia, risks to future pregnancy (such as placenta issues or hemorrhage) and risks to the baby (babies following cesarean often experience more respiratory difficulties than babies following vaginal birth).

Myth #3: Once a cesarean, always a cesarean.
FACT: While cesarean can be a life saving procedure, it is a procedure meant to be used rarely, not routinely. In the vast majority of cases, vaginal birth is the safest for both mother and baby including following a previous cesarean.

Myth #4: In Oklahoma, VBAC is only available “under the radar” or for a privileged few with “special permission.”
FACT: In Oklahoma, there are a variety of providers who provide VBAC services in a variety of settings. VBAC providers include both physicians (OB/GYN) and midwives. See the Oklahoma Birth Network Provider Guide and the ICAN website for details.

Myth #5: Repeat cesarean is more convenient than a VBAC.
FACT: Repeat cesarean takes weeks to recover from (average 6-12 weeks) while VBAC recovery is 2-6 weeks. Planning “the day” may initially seem more convenient yet the higher risks of the procedure, longer recovery time and the difficulty caring for yourself and other children far out shadow the initial convenience.

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VBAC in Oklahoma

TEN QUESTIONS TO ASK YOUR PROVIDER ABOUT VBAC

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1. Do you offer VBAC services at the birth site I plan to use?

These services are available in Oklahoma. Remember it is NOT illegal to have a VBAC in Oklahoma.While some hospital policies do not allow for VBAC services, these services are available in hospitals, birth centers and homes.

2. If you (and/or your birth site) do not offer VBAC services, can you refer me to another provider who does offer VBAC services?

If your provider does not provide services necessary for your care, you have a right to a referral to another provider who can.

3. Do you consider me a “candidate” for VBAC? Why or why not?

Providers should review with you your medical, obstetrical and prenatal history while discussing your wishes and desires before determining this. “Once a cesarean, always a cesarean” is not a valid reason to refer a woman for a repeat cesarean.

4. What are your VBAC rates and repeat cesarean section rates?

This will help you determine how often your provider attends VBAC births and their comfort level with these births.

5. What is your philosophy of birth?
While this may seem like a “silly” question, this is important for whatever kind of birth you plan to have. Your birth provider’s philosophy should be similar to yours and should give you insight into the kind of care they provide.

6. Do you treat VBAC women any different from other pregnant mothers?

If the answer is yes, this could be a red flag indicating that they see you as at a high risk for rupture or other complications. If you are not seen as the same as another laboring mom it could indicate that the provider may not fully support VBAC.

7. Under what circumstances do you recommend induction?

It is important to know a provider's philosophies on induction of both VBAC and non-VBAC moms. Inducing a VBAC mom increases the risk of complications which should be weighed against the reason for the induction. For most women reasons for induction should not include “going past a due date” or speculating a "big baby."

8. Do they have a time-limit on how long your pregnancy or labor can be before you recommend a
repeat cesarean section?

There should be no limit as long as baby and you are fine.

9. How would you feel if I wanted to be able to move around the room, labor away from the bed and
perhaps deliver in whatever position I want?
This will give you information on your provider's philosophy on continuous fetal monitoring that might restrict your movement and positioning in labor and birth.

10. Do you share an on-call schedule with other providers in your practice? Do they share your same
philosophies on VBAC?

This helps you prepare for a situation when your provider is not available for your birth. Having this conversation and following up with a birth plan signed by your provider can help to ensure their orders will be followed in your birth.

Just like any birth, both VBAC and repeat cesarean have risks. Be sure to understand the risks and benefits of VBAC versus the risk and benefits of repeat cesarean.

Oklahoma Birth Network and the Central Oklahoma International Cesarean Awareness Network (ICAN) provide this guide in the hopes of educating Oklahoma families and dispelling myths about Vaginal Birth After Cesarean (VBAC) in Oklahoma. Please contact either group for more information and support.

Childbirth Connection:
This organization provides comprehensive information on choosing a birth site, VBAC, cesarean, repeat cesarean, preventing pelvic floor dysfunction, stages of pregnancy, What Every Pregnant Woman Needs to Know
About Cesarean and A Guide to Effective Care in Pregnancy and Childbirth.

Coalition for Improving Maternity Services (CIMS):
This organization is “making Mother-Friendly care a reality.” They are the organization responsible for the Mother Friendly Childbirth Initiative (MFCI). Check out their “10 Questions to Ask” your provider and birth site to assess for Mother Friendly practices.

Text by Kathryn Konrad, MS, RNC-OB, LCCE; Brooke Smith, MS, RNC-OB;
Karen Prior,LCCE, (CD)DONA; and Taryn Goodwin, (CD)DONA
Designed by Samatva Productions
Publication of this pamphlet was made possible by a grant from Lamaze® International.