| I wrote this letter in response to a situation in our Central Florida birthing community. You may copy and use it if it will help you to make VBAC a viable option in your community. When reproducing, please include the last line sourcing the letter back to me. Thank you. For a PDF of the letter copied below please see VBAC letter. This PDF allows you to easily print a copy and sign your name at the bottom. Here is my Original VBAC letter written from a more personal perspective. Do not print and sign this one but you may use it to help you personalize your own letter. ----------------------------------------------------------------------- April 29, 2007 To Whom It May Concern: The environment in our community is such that families have few options for discussing the possibility of a vaginal birth after cesarean (VBAC). I encourage you to look at each woman on a case-by-case basis and be open to providing VBACs when your client is a good candidate for vaginal birth. The big topic when discussing VBAC is uterine rupture yet the statistics show that the risk of uterine rupture is quite low. “Overall, fewer than 1 in 100 women who labor after a cesarean experiences the scar giving way during labor, which generally leads to an urgent c-section. Researchers have found that some factors increase this likelihood. None of these factors raises this risk higher than 4 out of 100, and most do not raise it higher than 2 out of 100. In other words, 96 to 98 out of 100 women who have these factors will labor without any problem with the scar.”(1) Many women are being denied the opportunity for a VBAC despite the odds that they will most likely deliver without experiencing uterine rupture. “As you consider th(is), keep in mind that on average, 3 out of 4 women who labor after a c-section will give birth vaginally with care that encourages and supports VBAC (and fewer than 1 in 100 will experience the scar giving way). Even in cases where women scored 0 to 2 on a scale where 10 indicated greatest likelihood of vaginal birth, half gave birth vaginally.”(2) The other thing that is almost never discussed is the risks associated with surgical birth via c-section. “Compared with vaginal birth, cesarean section increases a woman's risk for a number of physical problems. These range from less common but potentially life-threatening problems, including hemorrhage (severe bleeding), blood clots, and bowel obstruction (due to scarring and adhesions from the surgery), to much more common problems such as longer-lasting and more severe pain and infection. Even after recovery from surgery, scarring and adhesion tissue increase risk for ongoing pelvic pain and for twisted bowel.”(3) Along with the risks mentioned above, there are many other problems associated with the c-section including extended hospital stays, interference with the breastfeeding relationship, and possible emotional side effects. There are also risks to the baby experiencing the birth via c-section and an impact on future pregnancies due to scarring in the uterus. At the very least I think a family should have the right to discuss their options, outline the risk factors for both a repeat c-section and a VBAC and determine with their care provider if they are a good candidate for a VBAC. Having a blanket statement that “we do not do VBACs” deprives many families of this opportunity and forces many women into surgery who may be the perfect candidate for vaginal birth. Please be open to discussing VBAC with your patients. Thank you for your time and consideration. Sincerely, Sources: 1. http://www.childbirthconnection.org/article.asp?ck=10211#planning
2. http://www.childbirthconnection.org/article.asp?ck=10210#c-section
3. http://www.childbirthconnection.org/article.asp?ck=10210#c-section
(Original letter written by Kristy de Gregory and reproduced here with permission. http://www.weewilliewinks.com/store/WsPages.asp?ID=8 ) | 
