VBAC
The medical practice of Dr. Elizabeth de Gouveia supports the informed choice of women and their families who seek to attempt a Vaginal Birth After Cesarean (VBAC). VBAC birth is an option for women who have preferably had one Cesarean section with a low-transverse uterine scar.
The following factors decrease risk for VBAC complications:
The following factors decrease risk for VBAC complications:
- Only one previous Cesarean section
- Only one previous Cesarean section
- A low-transverse uterine scar (as opposed to a scar from a vertical Cesarean incision)
- Active labour that begins within the full term of pregnancy (38 to 40 weeks) and not before or after the term.
- Regular appointments at our clinic to ensure that the pregnancy is progressing in a healthy manner and that both mother and baby are healthy.
- That the patient take the time to conduct the relevant research regarding VBAC risk factors and is therefore properly informed about the risks of uterine rupture and aware of issues that may arise. Monitoring of fetal heart rate during labour is essential, as well as for the labour to progress at an appropriate rate once active labour is established.
CESAREAN SECTION
Dr. Elizabeth de Gouveia is skilled at delivering babies by Cesarean section and strives to provide patients with an informed experience that allows patients to participate in the decision making process.
Options for anesthesia include:
Local anesthesia utilising a combined epidural and spinal block. This allows the patient to be awake during the operation and interact with baby after delivery. The baby can be given to the mother for skin-to-skin contact after delivery and breastfeeding if the mother so chooses.
- That the patient take the time to conduct the relevant research regarding VBAC risk factors and is therefore properly informed about the risks of uterine rupture and aware of issues that may arise. Monitoring of fetal heart rate during labour is essential, as well as for the labour to progress at an appropriate rate once active labour is established.
In the case of emergency Cesarean section:
or Cesarean section that becomes necessary due to complications that occur during an attempted VBAC, you can expect the following:
Should you or Dr. de Gouveia become aware of risk factors that may lead to an emergency Cesarean section, Dr. de Gouveia will exercise extra care in monitoring the progress of your pregnancy and labour to ensure a prompt and timely emergency response
In the case of VBAC, you may choose to:
1. Schedule an elective Cesarean section rather than attempting an in-hospital VBAC in the case that your labour does not progress, that there are concerns about the baby’s heart rate, your pregnancy continues past your due date, or you for any reason choose to not go ahead with an attempted VBAC.
2. Request Dr. de Gouveia’s presence at your labour in-hospital for an extended period of time (as opposed to being called in when you are close to delivery) to monitor your progress and consult with you regarding when would be the appropriate time to prepare for a Cesarean section. This type of open communication and planning is beneficial to you and your baby as it may prevent the need to wait for the operating theatre to be prepared and assistant medical staff to arrive. Please refer to the extensive research which relates fast response times to VBAC emergencies (such as uterine rupture) to improved outcomes for both mother and baby. It is important that you are aware of all of the factors involved in a successful VBAC and that an emergency Cesarean section is properly prepared for as a safety measure to ensure the best possible outcome for you and your baby.
