I find it interesting that moms who attempt VBAC (vaginal birth after cesarean) in our area seem to be treated the same whether or not they have had a prior vaginal delivery. Once upon a time, I am told, VBACers with a prior vaginal delivery were "allowed" to deliver at a birth center, but that was several years ago. I am hoping recent research will encourage doctors to be more supportive of moms who have had prior vaginal deliveries and would like to have a VBAC. A new study, Labor Outcomes with Increasing Number of Prior Vaginal Births After Cesarean Delivery, had these results:1
Among 13,532 women meeting eligibility criteria, VBAC success increased with increasing number of prior VBACs: 63.3%, 87.6%, 90.9%, 90.6%, and 91.6% for those with 0, 1, 2, 3, and 4 or more prior VBACs, respectively (P<.001). The rate of uterine rupture decreased after the first successful VBAC and did not increase thereafter: 0.87%, 0.45%, 0.38%, 0.54%, 0.52% (P=.03). The risk of uterine dehiscence and other peripartum complications also declined statistically after the first successful VBAC. No increase in neonatal morbidities was seen with increasing VBAC number thereafter.
To repeat, after one prior VBAC, your chance of success jumps from 63.3%-87.6%! That is no small increase. I can't help but suspect your chances for VBAC success might be greater with an HBAC (home birth after cesarean), assuming you feel safe at home. Many women who VBAC in hospitals require continuous fetal monitoring and are subject to staff who are nervous about VBACers, not exactly the best environment in which to let go, trust your body, and open up. I know the VBAC success rate of my midwife's VBACing clients is greater then 63.3% and she has attended quite a few VBACers in her day.
1 Brian M. Mercer, MD, "Labor Outcomes with Increasing Number of Prior Vaginal Births After Cesarean Delivery," Obstetrics and Gynecology 111 (2008):285-291.