This episode is heavy in numbers, which may not be your jam, but I want you to have good information that is not fear-based. Yes, some fear is involved because these scenarios are scary. But my purpose is so that you can make the best choice for yourself and your family based on truth.

You may have already had a C-section done out of your control and now face these tough decisions. That involves fear, and the best way to counter it is to know the truth. Something I heard from Dr. Stu and Dr. Shave at the Twins Breach Conference is this: odds for you are either 100% or 0%. When you hear a 10%, 12%, or 40% chance, you either have it or you don’t. If it hasn’t happened to you yet, it isn’t you. Gather the info, weigh it, and make your decision confidently.

Dr. Riley also mentioned the burden of proof in medicine. Why do we need a study to prove that we should deviate from nature? If we're operating on the side of what is natural, deviations happen occasionally, but usually things go as designed. To deviate, the medical side should prove that their way has better outcomes. God’s natural design is best.

Once you've had a C-section, it doesn't mean the end of the world or that you need another C-section. Today, we'll look at some numbers. For example, the C-section rate in America in 1970 was 6%, maternal mortality was 7 per 100,000. By 2020, C-section rate rose to 32%, maternal mortality to 24 per 100,000, and abnormal placenta formation increased. More medical intervention did not reduce maternal risk; it increased it.

A meta-analysis of 380,000 moms found that elective repeat C-sections resulted in more deaths than VBACs: 28 per 100,000 vs. 7 per 100,000. The risk for VBAC depends heavily on labor management, who takes care of you, and your care philosophy. The risk for elective repeat C-section is intrinsic to the procedure, including placenta accreta spectrum and placenta previa. These are serious risks, sometimes life-threatening, and usually impact future pregnancies.

Uterine rupture is often exaggerated. The actual rupture rate after one C-section is 0.2–1%, translating to three per 10,000 perinatal mortality. The majority of VBAC risks can be mitigated with proper care.

ACOG notes that women who fail a trial of labor are at risk for complications, but this is often due to how labor is managed, not VBAC itself. American College of Nurse Midwives strongly supports VBAC for appropriately selected and managed women.

Risk factors affecting VBAC success include labor augmentation, induction, maternal obesity, gestational age beyond 40 weeks, inter-delivery interval less than 19 months, and birth weight over 4,000 grams. Successful VBAC is associated with shorter hospitalizations, fewer infections, less blood loss, and fewer transfusions.

C-sections are occasionally lifesaving but not normal. Adding more C-sections can increase risks in future pregnancies, especially if you want more children.

More than 95% of women with a prior C-section should be able to have a trial of labor after C-section. The key is understanding what your providers are telling you and why. Are their recommendations truly for your best interest?

Next week, we’ll dig deeper into how you can increase your odds of a successful VBAC and decrease your chances of complications.

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If you want to learn more, check out my on-demand course at yourbirthgodsway.com/replaycourse
for guidance on how to prepare for birth God’s way—even if you've had a C-section before.