My question is for a dear friend of mine. She had a c-section with her first child four years ago (posterior baby/failure to descend). She wants to conceive a second child, and her OB says she's fertile and ready to go, but she estimates that if she conceived soon, by the time she gave birth she would be about age 46.
We live in Vermont, and our local hospital has just stopped doing VBACs because none of their anaesthesiologists are willing to be on-call 24-hours a day. The other nearest hospitals are in New Hampshire where we hear no hospital has done VBACs in a number of years, and Greenfield, MA, where they apparently just stopped doing VBACs as well.
She is open to the idea of homebirth, but is afraid that her "advanced maternal age" would bring risks that would tip the balance against homebirth. She has no red flag health issues that I am aware of.
Do you know of any studies that have shown how advanced maternal age influences risk when birthing at home (if at all)? She has looked around online but hasn't found anything addressing this particular piece of the puzzle.
She wants to birth in the least risky setting. An elective (or policy-mandated) c-section is not acceptable to her, and she might consider adoption or not having another child if she cannot plan a VBAC.
We both eagerly anticipate your response. Thank you so much.