For long now, obstetric practice has stopped conducting vaginal birth followed by a previous caesarean section and about nine in ten women in the United States end up in repeat caesareans.
A panel of experts from the National Institute of Health, recently recommended that obstetric practice revisit caesarean guidelines and actively perform ‘vaginal delivery after caesarean or VBAC’ on second time mums and allow mothers to give birth naturally.
The ‘once a caesarean, always a caesarean’ notion doesn’t seem to hold water today, with NIH experts claiming that VBAC is certainly a safe alternative for almost 70% of women who have had Caesareans, of whom 60 percent to 80 percent succeed. The older notion stemmed from the fear of a possible rupture of the scar on the uterus during labour, which can be life threatening for both the woman and the child.
The conference held in Bethesda, Md., by the National Institutes of Health raised concerns over the plummeting rate of VBAC’s to less than 10 percent from 28.3 percent in 1996 and an astonishing 50% increase in C-sec’s to 31.8 percent, which has been rising steadily for the last 11 years. However, data presented on the safety of VBAC and repeat caesareans at the conference showed that both risks are very small.
“One of the major goals of our panel was to be able to provide individual women with information on risk,” said Dr. Emily Spencer Lukacz, an associate professor of clinical reproductive medicine at UC San Diego. “Each individual woman will have different preferences and different levels of risk they are willing to accept in order to have the experience they are invested in having.”
“The tide is to walk away from VBAC. But the panel is making a clear statement that we need to understand and better address the nonmedical barriers to VBAC,” said Carol Sakala, director of programs for Childbirth Connection, a national non-profit organization that works to improve maternity care. “They want to give women the option of VBAC.”