VBAC

Question 1

Contraindications of VBACs (3)

Answer 1

Vertical uterine scar
3+ C-sections
Previous uterine rupture

Question 2

What is the success rate of VBACs

Answer 2

75%
25% have CS

90% success if had previous vaginal

Question 3

What are the chance of uterine rupture?

Answer 3

1/200

1/40 if need induction

Question 4

What 6 things are positive predictors of success in VBAC?

Answer 4

Spontaneous labour
<2yrs between pregnancies
Low age and BMI
Small foetus
Engagement of head
Previous vaginal delivery

Question 5

Advantages of a VBAC (4)

Answer 5

Greater chance of future vaginal delivery
Quicker recovery
Greater chance for skin-skin -> greater bonding
Reduced chance of respiratory distress of newborn

Question 6

What are the disadvantages of VBAC (6)

Answer 6

May need emergency CS
May need blood transfusion
May rupture uterus
May need assisted delivery
Risk of 3/4 degree tear
Small risk of stillbirth due to brain injury to baby

Question 7

VBAC Hx - 6 parts

Answer 7

How many previous deliveries?
Any vaginal births?
Hx of CS - why, what cut, how was post-op period
How previous children doing?
How is current pregnancy going - where is placenta, any complications eg. GDM
Family plan for future

Question 8

Homebirth disadvantages (6)

Answer 8

3x higher neonatal death rate
45% primips need to be transferred to hospital
Increased adverse outcomes
Can’t monitor baby’s heart
Can’t manage a uterine rupture - no blood transfusions
Limited analgesia options