VBAC in Minneapolis: What You Need to Know About Having a VBAC at Roots

When you’ve had a previous cesarean birth, you might have heard that your only option for future births is more surgery. But that’s not true! You can have a VBAC, or a vaginal birth after cesarean.

At Roots Birth Center, we welcome families who choose VBAC, and we are the only birthing facility in Minneapolis that supports having a VBAC waterbirth. We are also passionate about VBAC at Roots because of our own personal experiences. Our owner, Rebecca Polston and practice manager, Becca Fruncillo both had successful, midwife-attended VBACs.

Still, you may be wondering, “Is VBAC safe?” or “What are the risks with VBAC?” Read on for the answers to these questions and more information about having a VBAC in Minneapolis.

What is VBAC?

VBAC is an acronym for vaginal birth after cesarean, but you may have also heard the term TOLAC, or trial of labor after cesarean. Other common terms when discussing VBAC include elective repeat cesarean (ERCS), which is when the birthing person chooses to have a repeat C-section instead of planning a VBAC, and cesarean birth after cesarean (CBAC), which happens when someone is planning a VBAC but has another C-section.

Just like out-of-hospital birth is not for everyone, VBAC is not for all birthing people either. However, research shows that VBAC is a safe, reasonable, and appropriate option for healthy, low-risk pregnant people. At Roots, we practice evidence-based care, so we accept clients who choose VBAC, and water birth is an option for parents who are planning a VBAC.

Is VBAC Safe?

Yes, VBAC is safe for the majority of healthy, low-risk birthing people, and the most recent data shows that 74 percent of parents who plan a VBAC are successful and that rate is often even higher with supportive care providers. At Roots, our VBAC success rate is 96%! Some common factors that make you a good candidate for a VBAC include the following.

You’ve had only one prior C-section.

Your C-section scar is from a low, transverse incision.
It’s been at least 18 months since your last pregnancy.
Your previous C-section was because of a non-repeating factor, such as a breech baby or a twin pregnancy.
You’ve had a previous vaginal birth at some point.

These are not specific requirements for a VBAC at Roots, and we are happy to discuss your individual medical history and your wishes for subsequent births in order to personalize your care.

Why Choose a VBAC at Roots?

There are several benefits for the birthing parent when choosing a VBAC in Minneapolis instead of a repeat C-section. VBAC encourages spontaneous labor and physiologic birth, minimizing unnecessary interventions. Research shows this type of supportive, intervention-free care leads to greater satisfaction with the birth experience. An added benefit of selecting Roots is using water immersion during labor and birth to cope with the discomfort of contractions. Plus, not having surgery means you’ll have an easier recovery and avoid possible complications, like blood loss, incision pain or wound infection.

In addition, depending on your preferences for family size, you might be able to have more children if you opt for VBAC in Minneapolis. This is because, every time you have surgery, there’s an increased risk for complications, including ectopic pregnancy, stillbirth and preterm birth, and uterine rupture. Another dangerous complication is called placenta accreta, which is when part or all of the placenta penetrates the uterine wall and becomes inseparable. Therefore, the more cesareans you have, the more likely you are to experience complications in subsequent pregnancies. Planning a VBAC may help prevent these risks if you want to carry more children.

There are benefits for babies who are born vaginally, too. Evidence shows these newborns are less likely to experience breathing difficulties at birth, and the chances are lower that they’ll be separated from the gestational parent and need special care. This means skin-to-skin contact can begin immediately after birth, a practice that can help with breastfeeding and bonding.

What Are the Risks with VBAC?

Overall, the risks of both VBAC and elective repeat cesarean are low. However, it’s important to understand that both choices do come with benefits and risks. At Roots, we encourage discussion of benefits and risks, practice shared decision making, and respect our clients’ autonomy. We are here to share evidence-based information, and we trust you to make the best decision for you and your family.

So, what are the risks with VBAC? Well, the most common risk that you’ll likely hear when learning about VBAC is uterine rupture, which is defined as an anatomic separation of the uterine muscle. It’s a rare but serious complication for the gestational parent and the baby. Data shows the risk of uterine rupture is 0.4-0.9 percent. At Roots, the type of care we provide minimizes the risk of uterine rupture because we wait for you to go into labor spontaneously, and we don’t use medications that augment labor. Both of these factors have proven to be protective.

When looking at the evidence, the rates of blood transfusions and infection are slightly higher for gestational parents planning a VBAC over an elective repeat C-section. Meanwhile, the outcomes for babies also differ slightly, with the number of stillbirths and neonatal deaths being marginally greater for parents in the VBAC group versus those who chose a repeat cesarean.

How Does Racism Impact VBAC?

Another noteworthy aspect of VBAC is the role institutional racism plays. Data shows that white people are more likely to have a successful VBAC than Black, Asian, and Latina gestational parents. Why? It has nothing to do with the ability or physiology of Black, Asian, and Latina parents to give birth vaginally. Rather, VBAC rates are low among people of color because the reproductive healthcare system is, unfortunately, set up to discriminate against them.

At Roots, we are working diligently not only to improve all reproductive healthcare outcomes for people of color, but also to increase the VBAC rates for these folks.

Are you interested in learning more about VBAC at Roots? Set up a free consultation by calling us at 612-338-2784, scheduling a tour, or filling out our form!

Rebecca PolstonMay 14, 2021