VBAC and TOLAC during pregnancy

 

Vaginal Birth After Cesarean (VBAC)

Video taken from the channel: CanadaQBank


 

Birth After a C sections | Tips For first VBAC

Video taken from the channel: Life Forever Changed


 

Having a VBAC or Vaginal Birth After Cesarean?

Video taken from the channel: Well Rounded Momma


 

VBAC & TOLAC: Vaginal Birth After Cesarean Section Discussed by Dr Nari Heshmati

Video taken from the channel: DrNari


 

What is VBAC?

Video taken from the channel: UCHealth


 

Women Talk about VBAC

Video taken from the channel: Midwives of New Jersey


 

VBAC/TOLAC Explained. Everything about delivery after c-section.

Video taken from the channel: Med Twice


What is the difference between TOLAC and VBAC? Trial of labor after cesarean (TOLAC) is a planned or attempted vaginal birth after cesarean (VBAC). Sometimes, there is a need to change the plan, and a TOLAC results in cesarean birth after cesarean (CBAC). A birth is officially considered a VBAC once the TOLAC results in a vaginal delivery.

Choosing Between a Repeat Cesarean and a Trial of Labor after Cesarean (TOLAC) After cesarean delivery, a woman may choose to have a planned cesarean birth or choose a trial of labor for vaginal birth. It is likely that 60‐80% of women who try a vaginal birth after cesarean section (VBAC) will be successful. Attempting a VBAC is called a trial of labor after cesarean (TOLAC). Overall, about 60 to 80 percent of women who attempt a VBAC deliver vaginally.

If you decide to try it, you’ll need a caregiver who supports the idea. VBAC and TOLAC, they’re sisters but not twins. There are a lot of letters flying around pregnancy and birth but when it comes to the desire to have a vaginal birth after having had a previous cesarean section, there are two commonly used acronyms. However, there seems to be quite a divide surrounding the understanding and use of them.

2. If single low transverse incision, calculate woman’s predicted success for VBAC based on historical factors early in pregnancy using Figure 1 or other available prediction models. a. If patient has at least a 60% chance of successful vaginal delivery, offer TOLAC. If patient has less than 60% success predicte d, but wants TOLAC, refer to. Vaginal Birth After Cesarean: VBAC: If you have experienced a cesarean delivery, you are not alone.

If you desire to try a vaginal delivery after having had a cesarean, you should be encouraged by knowing that 90% of women who have undergone cesarean deliveries are candidates for VBACvaginal birth after cesarean. This calculator is based on the equation published in the article “Development of a nomogram for prediction of vaginal birth after cesarean” cited below. It is designed for educational use and is based on a population of women who received care at the hospitals within the MFMU Network. Women pregnant with twins attempting VBAC have similar outcomes to women with singleton gestations and did not have a greater rate of rupture or perinatal morbidity. (I have never had a twin mom attempt VBAC but it can be done!). What is a vaginal birth after cesarean delivery (VBAC)?

If you have had a previous cesarean delivery, you have two choices about how to give birth again: You can have a scheduled cesarean delivery; You can give birth vaginally. This is called a VBAC. What is a trial of labor after cesarean delivery (TOLAC)? A TOLAC is the attempt to have a VBAC. ABSTRACT: Trial of labor after cesarean delivery (TOLAC) refers to a planned attempt to deliver vaginally by a woman who has had a previous cesarean delivery, regardless of the outcome.

This method provides women who desire a vaginal delivery the possibility of achieving that goal—a vaginal birth after cesarean delivery (VBAC).

List of related literature:

VBAC in multiple pregnancies and fetal macrosomia.

“Handbook Of Obstetric Emergencies” by Dr Gunasegaran Rajan, Dr Muniswaran Ganeshan, Dr Tang Boon Nee, Dr Thaneemalai Jeganathan, Joe Chovan
from Handbook Of Obstetric Emergencies
by Dr Gunasegaran Rajan, Dr Muniswaran Ganeshan, et. al.
Obstetrical and Gynaecological Society of Malaysia,

Therefore, a woman who has had a Caesarean birth and subsequently becomes pregnant may not have any contraindications to labour and vaginal birth in that pregnancy and may choose to attempt a VBAC.

“Maternal Child Nursing Care in Canada E-Book” by Shannon E. Perry, Marilyn J. Hockenberry, Deitra Leonard Lowdermilk, Lisa Keenan-Lindsay, David Wilson, Cheryl A. Sams
from Maternal Child Nursing Care in Canada E-Book
by Shannon E. Perry, Marilyn J. Hockenberry, et. al.
Elsevier Health Sciences, 2016

If you required a Caesarean in a previous pregnancy because of issues such as fetal malpresentation (the baby’s position) or gestational hypertension (pregnancy­related high blood pressure) that may not necessarily recur in a subsequent pregnancy, your odds of a successful VBAC are particularly good.

“The Mother of All Pregnancy Books: An All-Canadian Guide to Conception, Birth and Everything In Between” by Ann Douglas
from The Mother of All Pregnancy Books: An All-Canadian Guide to Conception, Birth and Everything In Between
by Ann Douglas
Wiley, 2011

Many variables go into deciding whether a VBAC is a safe option; however, it is being performed more and more frequently.

“ICD-10-CM/PCS Coding: Theory and Practice, 2018 Edition E-Book” by Karla R. Lovaasen
from ICD-10-CM/PCS Coding: Theory and Practice, 2018 Edition E-Book
by Karla R. Lovaasen
Elsevier Health Sciences, 2017

Therefore, VBAC is associated with the fewest complications than elective repeat cesareans; however, a failed TOLAC is associated with more complications than an elective repeat cesarean (ACOG, 2010c).

“AWHONN's Perinatal Nursing” by Kathleen R. Simpson
from AWHONN’s Perinatal Nursing
by Kathleen R. Simpson
Wolters Kluwer Health, 2013

VaginalBirth after Cesarean (VBAC) Several studies haveestablished that women withalow transverseincision of the uterus can safely givebirth vaginally ina subsequent pregnancy.

“Spiritual Midwifery” by Ina May Gaskin
from Spiritual Midwifery
by Ina May Gaskin
Book Publishing Company, 2002

Possible reasons for this plan include a previous caesarean (a VBAC is not common practice for multiples), placenta praevia or other obstetrical or medical issues, or fetal positions that make vaginal delivery unsafe.

“What to Expect When You're Expecting 4th Edition” by Heidi Murkoff, Sharon Mazel
from What to Expect When You’re Expecting 4th Edition
by Heidi Murkoff, Sharon Mazel
Simon & Schuster UK, 2010

With a vaginal birth after cesarean (VBAC), the medical profession recognizes that the need for anesthesia may decrease, some surgical risk is eliminated, and hospital stays are shorter.

“Principles of Risk Management and Patient Safety” by Barbara J. Youngberg
from Principles of Risk Management and Patient Safety
by Barbara J. Youngberg
Jones & Bartlett Learning, 2010

Vaginal birth after caesarean section (VBAC) can be offered to women with history of a single uncomplicated lower segment CS, and where there are no contraindications for vaginal birth in the current pregnancy.

“Oxford Textbook of Obstetrics and Gynaecology” by Sabaratnam Arulkumaran, William Ledger, Stergios Doumouchtsis, Lynette Denny
from Oxford Textbook of Obstetrics and Gynaecology
by Sabaratnam Arulkumaran, William Ledger, et. al.
Oxford University Press, 2019

For more information on VBAC, see Chapter 15.

“Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family” by Adele Pillitteri
from Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family
by Adele Pillitteri
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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18 comments

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  • I have never realized that Pitocin made a VBAC more dangerous why would Doctors use it if it doubled the chance of Uterine Rupture?

  • Can you do a video or answer the question about doing a VBAC with pre-eclampsia? I had pre-eclampsia and GD with my pregnancy and was scheduled for induction at 38 weeks. But my baby had a PAC so was unable to be monitored and resulted in a c-section. Do pre-eclampsia and GD make your risk higher for a failed VBAC?

  • Sir plz reply plz ������ i m 47 n got married only two years before I did conceive two-time naturally during the last two years but unfortunately both of my pregnancies resulted in miscarriage during the 10 week.sir I have no baby yet I still want baby plz help me plz do some thing for me now m taking loprin 75 mg daily n gulcophage 1 +I daily sunnyday vit D inofolic sachet cod liver oil n folic acid sir now my Dr going to treate me with letrozole n hmg 75iui inj according to this schedule letrozole from third day of period to 7th day of periods mean for total five days then hmg masone 75 iui inj from 8day of period to 11th day then on 12th day after having follicular study I have to meet my partner Dr plz suggest further any med or treatment or precautions that will help me sir plz reply plz help me I can’t afford further miscarriage as I’m already 47 thank you so much my all love to u stay blessed

  • Good information, thank you for taking your time to inform women about the vbac decision. I would like to add though, there is another important pro vbac aspect which is breastfeeding extremely important for babies and moms increased successful breastfeeding rates after vaginal births. I think that health care providers often scare women about uterine rupture, which accurs only in 1% and could be treated properly if detected on time. Im not saying it shouldn’t be considered cause it is important to know. I would like to mention that i had a successful vbac with a 4,5 kg baby at 42 weeks and after augmentation with pitocin. I gave you a thumbs up:) have a good day!

  • I had a c section as my induced labour did not progress well, baby did not moved down or get into the birth canal. Am i a suitable candidate for a VBAC in future? is VBAC possible for my second baby if at all i get GD the second time as well? Please advice.

  • I don’t agree with what you said.Actually c sections have increased as the result of the medical business behind those c sections cuz a c section is more expensive

  • 36 weeks and have been denied by 4 doctors. Not due to me not being a good candidate but because of their policy of not want to do it cuz of the risk. Feeling hopeless

  • Great talk, until you got to talking about VBA2C. You pulled that 5% statistic out of your bum because that’s false. It’s around 2%, and the risk doesn’t go up very much at all with subsequent cesareans. Check ACOG and start offering VBA2Cs with women who are willing to attempt it. Cheer them on and let them know they can do it!

  • I had a c section 5 years ago cuz my aon was in distress n im 31 weeks now with my second my baby n i want to have a vbac but im still scared��

  • 5%? Every Obgyn, midwives, articles and etc. that I have spoken to have said vba2c is at 2%? And that is from some that support vbac and some who do not. so where did the 5% come from?

  • I have 2 children, my 1st was an emergency c section and my 2nd was a schedule c section, my choice. My youngest child is 8yrs old and I’m 15weeks pregnant with my 3rd. I would love to have a vbac. Will it be safe and ok for me? I do want to have a home birth but I do want to do what’s best for my baby and my body. Please help.. I do have an appointment with a vbac supporting doctor on May 9th, so I will have all the questions said to asked in this video. But is it not possible for me to have a home birth with the 8yr window?

  • i am currently 12 wks pregnant an have had 2 previous c-sections. my first c-section was 10 yrs ago and my second was 5 years ago i am due in November which will make this pregnancy 6 yrs apart from the last. i never had an medical reason to have had either one. I want to try a VBAC with this pregnancy. Do i have a good chance for a VBA?

  • What about bigger babies? I was induced with my first baby because he was estimated over 4 kilos. After about a day in labor I reached 3 cm but his head was still high up.
    In this situation would you recommend to try vbac or is it too risky with a bigger baby? I would like to also mention that both me and my husband are big people so a big baby is kind of to be expected…

  • I have c section in 2012 and have a vbac in 2017, and am pregnant and my doctor is saying that is c section and I don’t know why, am 35years this year. Pls doctor what do think.

  • I’ve had a C-section with my son I got induced I was at 7 cm and my sons heart rate started to go down so i had the c-section my son’s umbilical cord was wrapped around his neck three times i had a low transeves incision I had the c-section 4 years and a couple months ago I am currently 30 weeks pregnant and wanting to have a vbac am i good candidate to have a vbac?

  • I had 2 C-section my oldest kids one was emergency and the other one was too close I had my baby n3 natural but now I’m pregnant baby n4 fingers crossed �� ��

  • So my c section was done after I was induced… and I got dilated and all that, but my son was stuck because he was trying to come out sideways… I’m pregnant now.. but REALLY want to do a vaginal birth!

  • That was super informational, this gave me a lot to think about and triggered questions for my doctor. I had my first baby (only one so far) via c section, I went through labor, pushed for 3 hours and could not successfully push him out even with a vacuum attempt. My sons head was much too large (just like his dads haha). I thought for sure I’d be a great candidate for a vbac, I very much enjoyed the challenge and process of laboring (all of it was beautiful) and wanted to go through it again but with a 20% chance of success it makes me feel otherwise. Thanks again!