[Dr. Byrne] "One of the factors for considering your next pregnancy after having a cesarean section is the fact that your uterus has a scar.
Now that scar usually heals very strongly, but there is a risk that a woman going into labor might have that scar open and have the uterus tear.
This is known as a uterine rupture.
A uterine rupture has the potential of causing problems for both the woman and her child.
This is a rare event and it's one of the things that we're able to manage appropriately in a hospital setting equipped to allow a vaginal birth after cesarean section."
[Dr. Lauria] "Our goal is to make planning a VBAC as safe as possible for you and your baby.
We put an I.V. into your arm so that if we do have to do a C-section we can give you medication and fluids immediately.
But we don't connect it to the pole typically, unless they need fluids, so that they can be fully mobile.
[sound of baby's heart beating] We monitor your baby's heart rate very carefully, looking for signs of any drops.
And we call them 'fetal heart rate decelerations.' Most of the time these are the baby's response to either head compression or sometimes a little bit of umbilical cord compression.
And as long as they're not progressive, and they're mild, they don't mean the baby is losing oxygen.
However, when we see drops in the fetal heart rate, we try to make them go away through position changes, getting you fluid ...
But if we can't get them to go away, we don't really know if this is just part of the natural labor process or if it could be that the scar is opening.
In that setting we truly recommend that you undergo an unplanned C-section because we think, in that setting, it's really what's safest for you and your baby.
What's interesting is that even with our moving quicker to C-section, the women who plan a VBAC are still highly successful.
So even with this careful watching and moving quicker for fetal heart rate decelerations, the vast majority of women who plan a VBAC are successful."
