Thank you to the community of parents and birth professionals who have supported VBAC.com since 1998. Cesarean section is a life-saving intervention but is sometimes performed without a woman’s true consent. Today, more than ever, expectant families need access to information they can trust to plan and experience the safe and empowering birth that is right for them. So VBAC.com will continue to update the evidence on childbirth practices and provide mothers and birthing families with the tools they need to advocate for their own best birth. Look for our redesigned website in the next few weeks. 

Why We Are Updating the VBAC Education Project

Women and birthing families have the right to choose how, where, and with whom they want to give birth. It is a human right. 

The leading professional associations of obstetricians and gynecologists believe that women and birthing families should be fully informed about the benefits and harms of both a VBAC and routine repeat cesarean and that their birth choices should be respected. But the American College of Obstetricians and Gynecologists (ACOG) tells us that these conversations are not always taking place during prenatal care. 

Vaginal birth after cesarean (VBAC) is a safe alternative to a routine repeat cesarean and is recommended as an option by the world’s leading professional associations of obstetricians and gynecologists. But, in the United States, the majority of women with a prior cesarean are still encouraged to have a repeat operation. About 70 to 75 percent of women who labor for a VBAC have a healthy birth yet many birthing families in the United States who want to labor for a VBAC are not given a choice. Ultimately they must agree to a repeat cesarean section. 

The United States has recently severely restricted women’s reproductive rights. Denying women medical care if they choose to labor after a prior cesarean and giving them no choice but to have a surgical birth is also a violation of their reproductive rights. 

To make informed decisions about VBAC or repeat cesarean mothers need to know what choices are available to them and the benefits and risks of those choices. Without access to accurate information mothers and birthing families with a prior cesarean cannot make an informed decision. 

Routine repeat cesareans are not benign procedures. Each additional surgery puts mothers at risk for serious complications including life-threatening hemorrhage, blood clots, infection, surgical adhesions, cardiac complications, hysterectomy, uterine rupture, and a higher risk of placenta accreta spectrum disorder associated with higher risks of morbidity and mortality. Birth by cesarean also puts women at risk for a longer recovery, psychological stress, and post-traumatic stress disorder.

 Babies born by cesarean are at greater risk of having complications including breathing problems and asthma and are more likely to need specialized care from a NICU (Neonatal Intensive Care Unit). With a cesarean, babies are less likely to have skin-to-skin contact and to be exclusively breastfed. In future pregnancies, multiple cesareans increase the risk of miscarriage and preterm birth. 

First published online in 2015, the VBAC Education Project (VEP) was designed to provide transparency, clarity, support, and guidance regarding birth options available to mothers and birthing families with a prior cesarean to empower them to make decisions that are right for them. 

Since its publication in 2015, all major maternity care professional organizations have since agreed that offering mothers with a previous cesarean the option of VBAC is best practice. 

The updated evidence presented in the VBAC Education Project is based on current research and obstetric, nursing, and midwifery guidelines that respect patient autonomy.

Whether parents ultimately choose a hospital, birth center, home-based VBAC, or a repeat cesarean, this toolkit provides evidence-based information, helpful strategies, and trustworthy resources that will enable women with a prior cesarean to make their own decisions about how they want to give birth. The VEP updates will be published as a slide set and will again be available as a FREE download.

 My partners are working hard to bring these changes online as soon as possible. I am proud to be working with Jennifer Faye of Faycreative.com who is creating our new website and with Alberto Rigau, Creative Director of Estudio Interlínea who previously designed our 2015 edition of the VBAC Education Project. 

We are looking forward to our new look.