Is a VBAC After 3 C-secs Possible?

QUESTION

Dear Midwife,
I was just wondering what your thoughts are for VBAC's. I have had 3 C-sections and I am now pregnant again with my fourth. My first c-section was because I had high blood pressure. My second and third c-sections were because the doctor said that he doesn't think VBAC's are safe. So I listened to him.

Now after reading TONS of material on VBAC's, I now know that they are very possible. But what about after 3 previous sections? My scar is across, not up and down. The doctor said that my scars healed very well. But he did say that my uterus is staring to get thin. What does that mean?I no longer see the same doctor. Could you please give me some advice and my possibilities? Is there even a chance for a VBAC? Any help would be great because I would like to experience a natural childbirth. (I am 5 months pregnant right now.)

ANSWER

The American College of Obstetricians and Gynecologists recommends against VBAC for those who have more than two prior cesareans, and they are extremely cautious for those who have had two. It would probably be very difficult to find a provider who would do one given the litigation environment these days. If anything happened and you or the baby died, the provider would not have a leg to stand on.

-- Cynthia, CNM

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.