An article published on sciencedaily.com earlier this week discusses the findings of 60 studies, spanning 24 years, including 700,000 women in 13 countries and hundreds of hospitals to be published in the Journal of Advanced Nursing’s August issue. Click here to read the entire release on their site. According to the article, certain induction methods including AROM (artificial rupture of membranes), prostaglandins, the use of oxytocin infusion or combinations of those methods tend to result in fewer successful VBACs. Cervical ripening agents also correlate with a lower VBAC rate compared to women whose labor begins spontaneously. The authors of the studies are able to devise recommendations for practitioners based on the findings of these studies. These recommendations include, amongst other things, that practitioners should exercise caution in inducing or augmenting the labors of women who have had previous cesarean deliveries as well as a call for evidence based decision making to increase the rate of successful VBACs.
Read the full article and comment below. What factors do you think contribute to VBACs?
2 Responses
I’ve had two VBACs (C/S for low fluid/breech with 1st child). My 1st VBAC I was sent home in very early labor and later ended up delivering at home w/ paramedics due to precipitous labor. I think that the drug free birth and the ability to walk around during labor probably aided in the success of my VBAC. My 2nd VBAC was very different. I had labor pains off and on for a week, but I was a week overdue and had Gestation Diabetes. I was scheduled for an induction, but it ended up an augmentation as I was having very mild contractions when I went in. I was dialated to 1cm and they used a foley bulb and a small dose of pitocin to help things get started. They eventually increased the pitocin. I did eventually get an epidural, but I was already in transition and it didn’t really take. My water broke on its own at 10 cm. The 2nd VBAC was not quite as comfortable as my movement was limited by the pit and monitoring, but I think the fact that I’d had a previous successful labor was probably a factor in the 2nd success.