OBGYN’S on VBACS

July 21st 2010  –  Guidelines back vaginal births after C-sections by Denise Grady- New York Times

The American College of Obstetricians and Gynecologists has issued a new set of medical guidelines meant to make it easier for women to find doctors and hospitals that will allow vaginal birth after Cesarean, or VBAC (pronounced vee-back).

In 1985, only 6.6 percent of women with prior Cesareans were giving birth normally, but by 1996 the rate had risen to 28%.  In 1999 though, this trend was dramatically reversed when the Obstetrician’s group issued a warning that surgical and anesthesia teams were required to be present in case an emergency C-section was necessary.

Word spread, particularly in smaller hospitals (due to the extra costs involved in having a team of Docs just waiting around) and VBAC’S were again strongly discouraged.

In March of this year, the National Institutes of Health gathered a team of experts to examine this issue.  The panel re-affirmed that vaginal birth was safe for many woman with past Cesareans, and they urged the OBGYN’S to reassess their guidelines.

The main worry is the risk of uterine rupture during labor, which can severely harm both mother and child, and would require immediate surgery.

Like earlier guidelines, the new theory says that vaginal birth is safe for most women after C-section providing that the cut in their uterus was low and horizontal.  (It should be noted that 60-80% of women that attempt VBAC succeed.)

Personally, I’d tell women to do whatever feels right for you. When my own son was 2.5 weeks late, and the OB told me he was over 9 lbs and his head hadn’t dropped,  I told them to make me an appointment.  And not to be induced, but for a C-section.

Ironically, my young doctor had done his post-doctoral study project on reducing C-sections.  And then he met me.  I smiled through the event, and haven’t regretted it since.

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