Episode 79: VBAC Epidural Hospital Policy

Welcome to Birth Acadiana Podcast!Join us as we dive headfirst into the captivating world of pregnancy, birth, and postpartum, all right here in our very own community. I’m your host and local perinatal chiropractor Dr. Alayna Clark joined by my dear friend and co-host and Doula Tiffany Wyatt, we’re here to bring you a treasure trove of knowledge, wisdom, and personal stories. Our mission is to empower you with the insights and understanding you need to make informed decisions on your unique path to motherhood. We know the importance of those moments when you say, “ I wish I would have known better,” and we’re here to make sure you don’t have to. This podcast is your educational guide, your friendly companion through the beautiful, sometimes challenging, but always transformative journey of pregnancy and beyond.But remember, while our podcast offers invaluable insights, every woman’s experience is as unique as her fingerprint. Always consult with your trusted healthcare provider to make choices that are best for you and your baby. So, whether you’re an expectant mother, a curious partner, or simply someone eager to learn more about the miracle of life, we’re thrilled to have you along for this incredible ride.Welcome to the Birth Acadiana Podcast- where wisdom, support, and community (aka your village) come together to light your path to motherhood.VBAC Epidural Episode: Key Citations & SourcesACOG Guidelines"Epidural analgesia for labor may be used as part of TOLAC" (not required)ACOG Practice Bulletin No. 205: Vaginal Birth After Cesarean Delivery (2019)https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2019/02/vaginal-birth-after-cesarean-delivery73% success rate overall; 78.2% with epidural vs 76.8% without epiduralEvidence Based Birth Podcast Episode 113: https://evidencebasedbirth.com/ebb-113-the-evidence-on-vbac/Israeli study (17,516 women): https://pmc.ncbi.nlm.nih.gov/articles/PMC12176991/70% detected by fetal heart rate monitoring; only 10-15% by maternal painStatPearls - Vaginal Birth After Cesarean Delivery: https://www.ncbi.nlm.nih.gov/books/NBK507844/StatPearls - Uterine Rupture: https://www.ncbi.nlm.nih.gov/books/NBK559209/0.7-0.9% regardless of epidural useMultiple studies show no significant difference between epidural and non-epidural groupsFrench study: https://pubmed.ncbi.nlm.nih.gov/28622143/Finland/Sweden/Netherlands: ~50% VBAC rate; US/Australia: ~12% VBAC rateNone of the high-rate countries mandate epidurals for VBACTransforming Maternity Care (Australia): https://www.transformingmaternity.org.au/2021/07/strategies-that-work-to-increase-vaginal-birth-rate-after-caesarean/General anesthesia: 3-5 minutes; Epidural conversion: 10-15 minutesFor true emergencies, general anesthesia is faster and standard practiceStatPearls - Uterine Rupture: https://www.ncbi.nlm.nih.gov/books/NBK559209/VBAC Success RatesUterine Rupture DetectionUterine Rupture RatesInternational VBAC RatesEmergency Anesthesia