Until the 1980s researchers showed little interest in studying the outcomes of VBACs. The number of cesareans done today -- more than 800,000 a year, which is a fourfold increase over 30 years -- has been a real attention getter, especially at a time when governmental, medical, and consumer groups say there are too many surgical births.
The outcome for a woman and her newborn is usually better after a VBAC than a repeat cesarean, as hundreds of VBAC studies have shown. Encouraged by this positive trend, managed care insurance companies--health maintenance organizations (HMOs) and preferred provider organizations (PPOs) in particular-- have served to increase the number of VBACs by actively encouraging vaginal births and even on occasion refusing to pay for elective (i.e., not medically necessary) repeat cesareans. And, at least for two decades, an added catalyst for more VBACs has been consumer interest, led by persistent VBAC pioneers, both childbirth activists and healthcare providers.
Why I Wrote This Book
My job is not to persuade a woman who wants a repeat cesarean to have a VBAC. Instead, my challenge is to show those of you who do want a VBAC how to get one. This book will give you information about what helps and what hinders, guidelines on what to expect, and VBAC stories written in women's own words.