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Vaginal birth after cesarean section, or the slightly more conservative equivalent "trial of labor after cesarean" is still, for some reason, a controversial practice. Only a small percentage of obstetricians will feel comfortable with overseeing VBACs for various reasons, including the fear of litigation and their personal belief that repeat cesarean sections are safer than VBACs. An increasing number of women, however, is questioning the old motto of "once a c-section, always a c-section". If you are looking into having a VBAC, how do you find a provider who is comfortable with it?

There are various routes to finding a VBAC provider. We'll say immediately (without commenting on the safety issues, which we've addressed in other posts) that it will probably be a lot easier for you to find a doctor who will help you have a vaginal birth after c-section if you have had one c-section for non-emergency reasons than if you have three c-sections because of pelvic disproportion, for instance.

The type of incision you had, and other risk factors, also come into play. If you are a generally good candidate for a VBAC, perhaps the best way is to ask your current doctor whether she will oversee a VBAC, or to ask her whether she has colleagues who will do so. If your hospital or OBGYN clinic seems to be opposed to VBACs, and is insisting on a repeat c-section, you can contact ICAN (International Cesarean Awareness Network) to see if they can recommend a VBAC provider in your area.

Another good option is frequenting online forums for pregnant women, like Baby Center or Mothering, where there are women who live in your area. These women too can help you find a doctor who will do a VBAC. Sometimes midwives, including homebirth midwives, are much more comfortable attending a vaginal delivery after cesarean section than obstetricians are. If you are considering this route for yourself, consider that while a VBAC can be every bit as safe as a repeat cesarean section, and in many circumstances even safer midwives may not be equipped to deal with emergency situations.

This is even more true if you are thinking about having a homebirth after c-section. Instead of thinking that a homebirth is your only choice if you truly want a VBAC, you may be safer if you continue looking for an OB in a hospital, who will help you accomplish your goal of delivering vaginally.

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