Southern Arizona Expanding Options for VBAC

Sierra Vista’s Canyon Vista Medical Center will now support Trial of Labor after Cesarean (TOLAC) in order for expecting mothers to have the opportunity for a Vaginal Birth After Cesarean (VBAC).  Previously women in Sierra Vista and the surrounding areas of Benson, Fort Huachuca, St. David, Tombstone, and Bisbee drove to Tucson to attempt VBAC.

Jen Garate, Certified Nurse Midwife at Southern Arizona Midwives, says, “Canyon Vista Medical Center has always supported TOLAC. To provide the safest environment, hospitals require an on-site obstetrician and anesthesiologist. Previously, this was not consistently available, but staffing changes now make this support available at all times.” Jen partners with Dr. Michael Stevens, MD, FACOG, at Sierra Vista Medical Group to perform surgery if the TOLAC is not successful.  Garate and Stevens are both strong advocates for women having the option of vaginal delivery after cesarean in the correct circumstances and have supported several Trials of Labor already.

What extra precautions are taken for VBAC?

All patients desiring a Trial of Labor will have an IV and continuous electronic fetal monitoring. Other precautions can be discussed with the providers during the birth consultation visit.  TOLAC is only available to women with one previous cesarean birth.

Are there any risks that would require transport to Tucson?

Canyon Vista is equipped and staffed to handle all labor-related emergencies.  Anesthesiology is also now available 24/7.

Is induction available for women desiring VBAC? 

Induction is available for TOLAC. Mechanical ripening (Foley or Cook catheter) and medical induction using Pitocin are both options.

Are there any circumstances or health issues where a TOLAC would not be recommended?

Jen states, “Yes, there are many. The biggest is how and why the first Cesarean was done. If the uterus was cut up and down (vertical incision), TOLAC is not recommended and would not be offered. For this reason, any patient wanting a TOLAC would need to bring their surgical report with them to the consultation. Another example that would exclude a patient is persistent breech presentation. All patients are assessed to ensure they are a safe candidate for TOLAC.”

Additionally, Jen says, “Should a TOLAC not be recommended, my patients follow their birth plan as best as possible in the operating room,” which can include immediate skin-to-skin contact with mom and baby as well as delayed cord clamping.


Many thanks to Jen Garate, CNM, for providing information for this article and for being an advocate for women’s health. 

Jen was recently nominated for best medical provider in Sierra Vista  To VOTE for Jen, CLICK HERE.

Make an appointment with Jen today at

Blessed Birth, LLC is pleased to support clients in Tucson and the surrounding areas of Benson, St. David, Ft. Huachuca and Sierra Vista.

Questions about VBAC?  Check out this outstanding resource:

Photo courtesy of Galen Evans Photography.

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