Why do doctors fear vaginal birth after a previous c-section?

Uterine rupture. Not necessarily fear but a healthy respect for how quickly a normal labor can turn into a catastrophic uterine rupture with hemorrhage, emergent surgery, & potential maternal or infant loss. Uterine rupture can happen in the best of candidates for vbac and are often unpredictable. In today's legal climate, many obs will not risk any complications that can be avoided. Some hospitals forbid vbac.

Related Questions

Can I request a c-section instead of having a vaginal birth? I’m scared of giving birth and would prefer to have a c-section. Is this something I can request of my doctor?

While . While fear of childbirth is a totally understandable response to an unpredictable, new, and potentially pain-inducing life event, there are healthier ways to face and overcome your fear of childbirth than elective c-section. Ironically, requests for elective c-section (meaning that it’s not medically necessary) are becoming increasingly popular, at a time when natural childbirth is also experiencing a renaissance. Reasons your might request an elective c-section include: 1. Wishing to avoid a long, painful labor 2. Scheduling birth in your busy day planner 3. Being delivered by the doctor of your choice 4. Avoiding going too far past your due date, which can increase the risk of complications with the baby 5. Lowering the risk of postpartum hemorrhage when compared to either planned vaginal delivery or unplanned c-section 6. Fear of sexual dysfunction or urinary incontinence (although elective c-section has not actually been shown to reduce these risks) what many don’t realize, however, is that elective c-section is much riskier than vaginal birth. Risks include: 1. Greater pain postpartum 2. Longer recovery 3. Higher risk of postpartum infection, surgical wound complications, hysterectomy, anesthetic complication, blood clots, and other postpartum complications 4. Greater risk that the baby will have respiratory problems at birth, especially if c-section is done before 39 weeks gestation without first doing an amniocentesis to make sure the baby’s lungs are mature 5. Increased neonatal death rate 6. More risk in future pregnancies, including the risk of placenta previa and accreta, uterine rupture which may result in death of the baby, and surgical complications such as bladder injury, bowel injury, and scar tissue. If you understand these risks and wish to request an elective c-section anyway, go ahead and bring it up with your doctor, but understand that some doctors might say no, and your insurance might refuse to cover it. It’s your body and your choice, but although elective c-section is becoming increasingly popular in countries like brazil, it’s still far from the norm in most countries. Instead of seeking ways to avoid your fear of childbirth, consider leaning into your fear, using it as an opportunity to be present with fear, learn from it, and realize you need not let fear keep you from living the vital, joyful, fully-expressed life that is your birthright. Read more...
This . This seems to be the question of the day so many are asking in one way or another. The answer is not so straight forward. On the one hand you as the patient should have autonomy over what medically happens to your body, on the other is the issue of taking unnecessary risks. Regarding "cesarean section on maternal demand" as it is known in the literature and among those of us who discuss it on the lecture circuit, there are many variables. First, we look at risks and benefits and compare these to the alternative, vaginal birth. Simplistically there seem to be minimally more risks to the mother from a cesarean delivery including infection, hemorrhage and future risks of a ruptured uterus or scar tissue in the belly possibly affecting a subsequent pregnancy. Vaginal birth carries separate risks perhaps mildly greater to the baby though there remains debate even around whether this is true. These include among others, tearing, urinary problems, falling bladders and a descending uterus. In a nutshell. If you are appropriately consented as to the risks, benefits, and alternatives, it probably should be a mothers choice. We providers and the health system in general want to minimize harm to our patients, though debatable, minimizing cesarean deliveries to those medically necessary is thought to be an important goal. Hope this helps start the discovery. Read more...