Deborah Howell (Host): Vaginal birth after cesarean or VBAC refers to the vaginal delivery of a baby after a previous delivery by cesarean section. For many people, VBAC can be a safe and successful delivery option, but how do you know if it's right for you?

Intro: This is Weekly Dose of Wellness, brought to you by by Memorial Care Health System. Here's Deborah Howell.

Host: Welcome. I'm Deborah Howell. And today, we'll be talking about the benefits of VBAC with Pat Evans, a woman's healthcare nurse practitioner and certified nurse midwife at Memorial Care Medical Group delivering at Orange Coast Medical Center. Welcome, Pat.

Patricia Evans: Thank you. Thank you. Glad to be here.

Host: Really glad to be talking to you about this. What really is VBAC?

Patricia Evans: So, a VBAC is a vaginal birth after cesarean, and it's also called a TOLAC. A lot of practitioners will use that, which is a trial of labor after cesarean.

Host: Okay. And why would a person choose VBAC?

Patricia Evans: There's many benefits to it. Number one, it's no surgery. The recovery time is a lot quicker. There's a lot less pain afterwards. You get up and back to your life quicker, and it just safer.

Host: Okay. These seem like these are major benefits of VBAC. Are there any others?

Patricia Evans: I would say that those are the major ones. One of the other benefits is that you just get up and move around easier. You haven't had a major surgery, which a cesarean section is a major surgery, so you get back to life faster and recovery's faster.

Host: And, you know, be there for your kid a little bit more.

Patricia Evans: Right. Exactly, exactly. Breastfeeding is easier because you can move around easier. You go home faster from the hospital, usually in 24 hours. Whereas cesarean section, you're there usually about 48 to 72 hours, so you can go home a lot quicker, get back to life.

Host: That's all good. Now, what are the risks of VBAC?

Patricia Evans: One of the major risks, which is actually very low is a uterine rupture, but the risk percentage is only 0.4% to 1.2%. They're very, very rare. That's pretty much about the only one. Sometimes you can have a placental abruption, but you can also do that just in a normal delivery as well. So actually, it is very low risk when you consider the percentage rates.

Host: All right. And now, what kind of factors make someone a more successful or less successful candidate for VBAC?

Patricia Evans: Having a vaginal birth before, like maybe they had a vaginal birth and then they had a breach and they had to do a C-section, and then they've already had a vaginal birth, so they're an excellent candidate for a VBAC. Weight sometimes, like within a normal BMI below 30 is an advantage. Yeah, that's pretty much about it.

Host: Okay. And what should a person expect during a VBAC delivery?

Patricia Evans: Pretty much everything that they'd expect during a vaginal birth. There's nothing different. You're still going to go through labor, you'll still have the contractions.

Host: Okay. And let's talk a little bit about the recovery. What's that like?

Patricia Evans: Very quicker. Much sooner. Just like I mentioned before, you go home, like usually in 24 hours. Whereas cesarean, you usually stay like at least 48. And the recovery is just so much quicker. I think that's the major advantage. And plus, if you have to go back to work, if you don't have postpartum benefits, you can go back to work a lot quicker.

Host: Is VBAC becoming more normalized?

Patricia Evans: Oh, very much so. Yeah, we strongly encourage it.

Host: And do you have any advice for people who might want to have a VBAC?

Patricia Evans: To be patient. Not all VBACs are successful. We have a very high success rate at Orange Coast. Nationally, they're between like 54 and 94%, and the average is 74% of having a VBAC, which is really high.

Host: Yeah, that is. That is. All right. I'm very interested in this next thing that I'm going to talk about. Can you tell us about the childbirth Center at Orange Coast Medical Center and its unique benefits?

Patricia Evans: Oh, sure. The benefits are the nursing staff is excellent. We have a laborist who is employed by the hospital. It's an OB-GYN. It's there 24/7 should anything happen very quickly and we have to deliver quickly. They can do everything. We have a level two NICU, a neonatal intensive care unit. We have a neonatologist on staff if there's anything that the baby needs right away. And we're a very quiet unit. We do a lot of deliveries, but it's quiet. The nurses are just wonderful. We have lactation consultants afterwards to help moms breastfeed. And it's just a very friendly place. We love what we do. It's exciting because there's nothing better than delivering a baby.

Host: Right. And then, the aftercare and support is so important to a young family.

Patricia Evans: Oh, it is. And we have so much of that, the postpartum. We're all one unit. So, the postpartum is right next to the labor and delivery, and you just go over. And, yeah, the facilities are really nice. The rooms are all cheery and upbeat. And, you know, it's new life, so it's perfect.

Host: So, the new couple goes home with their baby and they have a concern. What happens then?

Patricia Evans: They just call us. They call the office, the medical group at the office. We have a 24-hour nurse advice line, and there's always one of us on call. So if it's like they need to talk to one of us, they'll just put the call through to us on our phone, no matter where we are.

Host: Okay. Sounds good. Is there anything else you'd like to add to our conversation?

Patricia Evans: No, I think that's it. It's just a wonderful place. We have a lot of fun. We're a very well run team. We like each other. And yeah, we just have a lot of fun.

Host: Well, it should be, because it's all about joy as a matter of fact, right?

Patricia Evans: Exactly. Exactly.

Host: Well, this has been so, so interesting. Thank you so much, Pat, for your time and your expertise today. We really enjoyed having you on the podcast.

Patricia Evans: Great. Well, thank you so much for letting me share what I love to do best.

Host: Our pleasure and you can find out more at memorialcare.org/ocbaby, or call the OCMC Childbirth Center at 714-378-7000. For more info or to listen to a podcast of this show, please visit memorialcare.org. That's memorialcare.org. That's all for this time. I'm Deborah Howell. Have yourself a terrific day.