Colquitt Regional has emphasized its commitment to superior women’s healthcare in recent years with the renovation of its Labor and Delivery Unit and building a state-of-the-art outpatient women’s clinic. In addition to improved facilities, they are also offering women expanded options for their birthing experience. Vaginal birth after cesarean section, also known as VBAC, is one of the unique practices available at Colquitt Regional that is not usually considered by other hospitals in the region because of its risks. Common practice often dictates that if a woman delivers a baby via C-section, then any subsequent births will be delivered by C-section as well.
C-sections are necessary when a patient is not able to give birth vaginally and must undergo the surgical cutting of the abdominal wall and uterus lining to remove the baby. Board-certified OB-GYN Jim Small, MD, M.Ed., FACOG, explained that there are many factors that can contribute to an emergency C-section.
“They can happen for a number of reasons,” he said. “Sometimes the baby just won’t fit through the mother’s pelvis, or sometimes it can be the baby just doesn’t like going through labor. Fortunately, emergency C-sections are the rarest of all C-sections.”
Small, who has been with Sterling Center Women’s Health for over three years, said that he has delivered about 150 of the 400-500 babies delivered in the hospital each year. Of those, Small said, they were mostly vaginal births, and over a hundred of those were successful VBACs. Sterling Center Women’s Health providers practice and deliver exclusively at Colquitt Regional.
For an expectant mother who wants to attempt a VBAC, Small said there are certain criteria that must be met.
“This is done in conjunction and counseling with the obstetric provider such as myself,” he said. “We look at a number of factors to consider potential success to deliver vaginally. The most significant of these factors is of course why they had the first C-section. Our hospital is fully equipped to manage the potential risk of attempting this delivery. The biggest emergency risk is actually less than 1 percent, which is related to the prior uterine scar from the previous cesarean delivery.”
Not every woman is a candidate for VBAC, but Colquitt Regional welcomes the opportunity to discuss the possibility. Furthermore, Colquitt Regional is one of the few hospitals in the region that even considers performing VBACs, according to Small.
“The biggest risk with a VBAC is actually related to the uterine scar,” Small said. “There’s approximately a 0.7-percent chance that that scar could tear during the throes of active labor. Consequently, the reverse is actually a 99-percent chance that this scar will remain intact. However, this is the main reason we have the greatest concern about attempted VBAC because if the scar did tear it can present as an emergency cesarean delivery, which has its own set of complications.”
With that being said, any mother who has agreed to attempt a VBAC is monitored closely during pregnancy and throughout the course of labor. Small also said that the key to a successful birth is based off of excellent care while pregnant and in labor. To ensure that all attempted VBACs have a great likelihood of success, Colquitt Regional has adopted a team approach. Board Certified anesthesiologists, OB-GYNs, a nurse midwife, and the staff of the Labor and Delivery Unit have worked together to put protocols and safe practices in place for all VBAC procedures.
“This means that a mother should come to the office as soon as she realizes she may be pregnant and followed along throughout the pregnancy with regular visits and care,” Small said. “All of the studies have shown that good prenatal care leads to the best outcomes.”
Colquitt Regional offers the crucial service of providing expectant mothers the attentiveness and care they need to have a safe delivery. Small offered some advice to make the experience easier and safer.
“My advice to all mothers is to make a plan for what they would like their birth to be, but understand the key word is ‘flexibility’ because, in reality, the one in charge of the birth is actually the baby,” he said. “We’re simply here to make the experience the best possible, and our team works on that from your first prenatal care visit through the entire pregnancy, through the prenatal classes, through the birth experience, and into the subsequent postpartum time.”
The motto Sterling Center Women’s Health goes by is “for women, for life,” which Small believes they stand by to the fullest extent.
“I’m very proud of what we have to offer for women here at Colquitt Regional Medical Center and Sterling Center Women’s Health,” he said. “This facility is one of the finest in the state of Georgia, and I believe we are privileged to take care of the women in this community.”
Small practices alongside Linnea Mehls, MD, and Michelle Holzman, CNM, APRN, at Sterling Center Women’s Health, part of the Sterling Physician Group located in Moultrie, Georgia.