MANSFIELD — Women who’ve previously delivered a child through cesarean section now have the opportunity to deliver vaginally at OhioHealth Mansfield Hospital.
Lindsey Blair, clinical nurse manager in OhioHealth Mansfield’s emergency department, is the mother of five children. She delivered her first three vaginally — but labor complications with her fourth child required an emergency C-section.
While expecting her fifth child, Blair admitted she had concerns related to her delivery.
“I was nervous that I would have to have a C-section or go down to Columbus — if I wanted to choose a vaginal delivery again,” she said.
OhioHealth Mansfield began offering VBACs, which stands for vaginal birth after cesarean delivery, in June 2023 — about two months after Blair became pregnant.
“I was very very excited to learn that I could continue with my OB group here and stay locally for my care,” Blair said.
On Jan. 4, she became the seventh patient to have a successful VBAC at OhioHealth Mansfield with the birth of her son, Deacon.
‘Benefits outweighed the risks’ for Blair’s situation
Having previously experienced the recovery process after a C-section, Blair was motivated to try a VBAC.
With a toddler at home, as well as three other children, she wanted to be physically able to help raise her family earlier than six weeks post delivery.
“It was important since I had a toddler at home, who was also very dependent on having me lift and do things for his daily activities,” Blair said.
“Having that VBAC afforded me the opportunity to not miss out on some of those things.”
Several health risks are possible with VBACs, including uterine ruptures. But Blair was willing to face the possibilities.
“I just think in my situation, the benefits outweighed the risks and I knew I was in good hands here (OhioHealth Mansfield),” she said. “We had talked thoroughly about it at probably every one of my OB appointments.”
“They were very good at explaining everything and really encouraged it (VBAC) and said that I was a good candidate for it.”
OhioHealth Mansfield has OB doctor 24 hours a day, seven days a week
Michael Parker, practice medical director for the OB hospitalist program, assisted OhioHealth with efforts to begin offering VBACs at the Mansfield hospital.
Parker works for Pediatrix Medical Group of Ohio. The company contracts with OhioHealth Mansfield to provide its OB hospitalist services.
“We’re the chief safety officers of labor and delivery,” he said. “We’re here to make sure that a healthy mom and baby come in and a healthy mom and baby leave.”
The doctor said the Mansfield hospital wasn’t offering trial of labor after C-section prior to Pediatrix’s arrival.
“I did work with the department to be able to coordinate efforts to start the trial of labor program after cesarean section and having an OB doctor in-house 24 hours a day, seven days a week makes that possible,” he said.
VBAC risks and advantages
A risk associated with VBACs can include C-section scar ruptures, which occurs about every three times per 10,000 pregnancies, Parker explained, adding other concerns include increased risks for bleeding and infection.
Some advantages of successful VBACs include avoiding another abdominal surgery and the possibility to have future vaginal deliveries, he added.
“If we can, and the patient is a good candidate, we like to encourage them to try a trial of labor after cesarean section,” Parker said.
Desired candidate qualities include no more than two previous C-sections, a prior vaginal delivery before a C-section, women who’s C-section was due to non-labor reasons and for the baby to be in the head down presentation, the doctor explained.
“The success rate of trial of labor after cesarean section is around 60 to 80 percent — depending on the indication for the first cesarean section,” Parker said.
“If you’ve never had labor and your cesarean section was done for say, a breach presentation, your chances of having a vaginal delivery after a cesarean section is just as good as if you’ve never had the cesarean.”
Women’s health a major focus for OhioHealth Mansfield
With VBACs now offerred to eligible candidates at OhioHealth Mansfield, expecting mothers have a local option for this type of delivery.
“There’s been a really big push in women’s health right now — to up our services, care and safety,” Blair said. “That’s been a really big point for OhioHealth this year.”
Parker echoed similar sentiments, explaining the OB hospitalist program and offered services benefits people who live in the area, as well as the physicians, community and hospital.
The eighth successful VBAC recently occurred at the Mansfield hospital April 28.
“Proper selection of the appropriate patient to have a trial of labor after cesarean is important,” he said. “Some women are not going to qualify, but a lot of women are.”
“It’s a discussion to have with a physician and I think a lot of women don’t know to have that discussion at this period of time because they don’t know that it’s being offered here.”
Parker said cesarean sections are one of the most common procedures performed in the United States and are currently on the rise.
“If we have the ability to offer more trial of labor after cesarean section, we may be able to affect that rate of those that are being performed — but also reduce the maternal complications and risks associated with repeat cesarean sections all-around,” he said.
