Are there practices or procedures used in VBAC that I should try to avoid?
You should try to avoid the following practices because no research shows they are beneficial and, in fact, they can reduce the chance of vaginal birth, increase the risk of harm and/or increase discomfort.
- Internal monitoring of contraction pressures (not the same as internal monitoring of the baby's heart rate). Some people believe that if the scar ruptures, internal contraction monitoring will alert your provider to this fact because the contraction pressure will drop, but studies have not supported this. Internal monitoring increases the risk of uterine infection and limits movement during labor.
- Banning women from eating and drinking during labor. Some providers are concerned that if the woman ends up needing general anesthesia for a last-minute C-section, she could get an infection by vomiting and inhaling the vomit into her lungs. However, C-sections rarely require general anesthesia and when it is used, a tube is inserted to make sure the woman can breathe. If hospital staff won't allow solid food, ask for frequent sips of clear fluids, which are rapidly absorbed into the bloodstream.
- Routine intravenous (IV) drip. If the hospital requires an IV line, ask for a heparin or saline lock. In this case, the IV needle is inserted with a short piece of tubing attached and heparin or saline keep the needle from clogging. In an emergency, an IV bag can be connected immediately.
- Routine internal examination of the uterine scar after vaginal birth. This is extremely painful for a woman who doesn't have an epidural; it could introduce infection; and it could turn a small, harmless gap in the scar into a problem.
If your care provider recommends any of these practices, you may want to discuss the specific risks and benefits to you and your baby before deciding.