A lot of expectant mothers hope to have a vaginal delivery of their second child, even if they had a cesarean the first time around. The procedure (commonly called a "vaginal birth after cesarean" or "VBAC"), however, is not without its risks. If you, your wife, or your baby were harmed during the attempt at a VBAC, the doctor may bear liability for allowing you to take the risk. This is what you should know.
Why is a VBAC so dangerous?
A VBAC is actually successful almost 76% of the time, but it's a mistake to think that every expectant mother's odds of having a successful VBAC are going to be 76%. There are a number of reasons that any individual woman's odds of success are drastically lower. Only someone who is a good candidate is for a successful VBAC should be encouraged to attempt one and every woman should be educated about the possible risks -- because even a good candidate faces a nearly 1 in 4 shot of needing an emergency cesarean anyhow.
One of the biggest risks of failed VBAC is a uterine rupture. When that happens, the baby can be deprived of oxygen and die very quickly. In addition, the mother can bleed to death. Approximately 6.2% of uterine ruptures result in the baby's death and somewhere between 14%-33% of women who suffer one have to have an emergency hysterectomy, which will end their chances of having another child permanently.
How can a doctor tell if a woman is a poor candidate for a VBAC?
There are many women who are simply poor risks for a VBAC, even if that's what they want to do. Doctors should carefully screen out women who are likely to endanger themselves or their babies during a VBAC. There are a number of factors that indicate a VBAC isn't a good choice:
- Women who had to have a cesarean due to a large-sized baby (subsequent babies are often bigger)
- Women who get pregnant too soon after their previous cesarean, which can take 18-24 months to fully heal.
- Women who attempted labor but had a failure to progress and never dilated beyond a few centimeters.
- Women whose cesarean scars are low vertical, "T" shaped, or who have had several cesareans.
- Women whose labor has to be induced with drugs that cause overly-intense contractions.
- Women whose babies are already at 40 weeks or longer of gestation, because the baby may be too big to deliver vaginally.
All of these things, plus other factors, put a woman at risk for a failed VBAC, which could unnecessarily fatigue the mother and even lead uterine ruptures. When that happens, there is an increased risk of a uterine rupture. Fully 87% of uterine ruptures occur with expectant mothers who have had previous cesareans.
If your doctor encouraged a VBAC and the results were devastating, it can feel like a tremendous betrayal to find out that your doctor should have known better because certain risk factors applied. If that's your situation, consider contacting a birth injury lawyer for advice and to discuss the possibility of a lawsuit. For more information, contact companies like Snyder & Wenner, P.C.