vbacguidelines
Click here to calculate your chance of vbac success.
Use prepregnancy weight in formula.
• recognize that while a successful VBAC is better than a scheduled c-section, a failed VBAC is much worse.
• we are very capable obstetricians with lots of VBAC experience and a high VBAC success rate. We are not afraid of VBAC but have seen the tragic results of complications of labor after c-section. The guidelines below are designed to both maximize your success at VBAC while maximizing the safety for you and your baby
• we strongly recommend that a doula be hired
• we require a well motivated woman and preferably partner too
• best approach is to wait for spontaneous labor
• all labor even early labor should be done in the hospital
• reasonable to accept repeat c-section if not in labor and an indication for delivery arises like preeclampsia or oligo
• reasonable to accept c-section if no labor by 41 weeks
• reasonable to accept c-section if LGA fetus
• an assessment by anesthesia staff once admitted is required
• IV access is required
• when in labor, only clear liquids/no food, ISE as soon as feasible, continuous monitoring is required
• early epidural is strongly discouraged. IV stadol or demerol will be given
• low dose oxytocin is often required after epidural to sustain labor momentum. It should be accepted
• forceps often can allow vaginal delivery for those who have appropriate decent and position of the fetal head
• episiotomy is not routine but should be accepted if fetal trace warrants sooner delivery or for forceps.