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Vaginal Birth After C-Section...An Option at BCH

June 7, 2021

The Boone County Hospital Family Birth Center staff and physicians are pleased to offer a safe option to delivering mothers that has been available to patients since May 2019.  Prior to May 2019, when a patient had a cesarean section, they had the choice of a repeat cesarean section in Boone or to be transferred to another facility for the option of a trial of labor after cesarean (TOLAC), also commonly known as vaginal birth after cesarean (VBAC).  Boone County Hospital (BCH) and physicians offer the option of VBAC locally.

There has been a lot of news coverage nationally about safe delivery of care for mothers in the United States.  One of the contributing factors to some of those significant complications can be tied to the high cesarean section rate in the United States.  For every cesarean section a woman has, her risk of complications increase.  BCH physicians and staff have been working hard to prevent those unnecessary cesarean sections with one-on-one care in labor and actively managing interventions in labor.  The current primary (first) cesarean section rate at BCH is well below the national average and offering VBAC as an option is just another way to reduce additional cesarean sections for patients.

Dr. Rienera Sivesind and Dr. Lindsey Hay, Boone County Family Medicine, will discuss the option of VBAC with their patients in the prenatal period to allow patients to make an informed decision about the delivery option that is best for each situation.  Patients will be carefully evaluated to determine if VBAC is a safe option for delivery.  Once it is determined that VBAC is an option, the risks and benefits will be shared with the patient and she can choose which delivery path is best for her.

There are some very specific criteria in the guidelines to assist the physicians in deciding who is going to be a safe candidate for VBAC.  For example, the doctors will need to know how many previous cesareans the patient has had and the reason for those cesarean sections.  “We want to ensure we are providing a safe option for our patients and careful evaluation of all risk factors is essential to knowing for whom VBAC will be a safe option,” said Dena Sytsma, Family Birth Center Director.

The opportunity to offer VBAC at BCH is a hospital-wide endeavor.  In addition to the Family Birth Center staff and physicians, the Surgical Services Department and anesthesia providers are actively involved in creating a plan to ensure a safe delivery in the event the patient attempting TOLAC would have complications and need another cesarean.  The hospital Board of Directors and Administration are also excited to continue to offer this option for our community members.

We hope by continuing to offer VBAC as an option we can have an impact on a specialized group of patients that will benefit from the option.  If you would like to know more about delivering at BCH, you can contact the Family Birth Center at (515) 433-8400.  You may also make an appointment with either of our delivering physicians by calling the offices of Dr. Rienera Sivesind or Dr. Lindsey Hay at (515) 432-4444.

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