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Tuesday, March 9, 2010

Bringing Back VBAC: Good for Women and Babies?

Lamaze International urges that most mothers with a previous cesarean section should be offered the opportunity to have a VBAC.

[USPRwire, Mon Mar 08 2010] Next week’s National Institutes of Health meeting on vaginal birth after cesarean (VBAC) will explore one of the biggest controversies in childbirth. Is VBAC a reasonably safe birthing option for women and their babies?
A growing number of women are counseled by their health care providers that VBAC is too risky – citing a fear of uterine rupture, a rare, but potentially dangerous complication – and told that a repeat cesarean carries little threat of harm. As a result, the VBAC rate in the United States has plummeted.
In the late 1980’s and mid-1990’s VBAC rates steadily increased, hitting a high of 28 percent in 1996. However, a decade later, fewer than 1 in 10 women delivered by VBAC (8.5 percent). Experts attribute the shift to several malpractice lawsuits, which influenced practice behaviors by obstetricians.
One of the key issues for the experts convening at the NIH next week is whether current VBAC practices are driven by research and data.
“There’s medical evidence that shows that most mothers with a previous cesarean section should be offered the opportunity to have a VBAC,” said Debra Bingham, president-elect of Lamaze. “Yes, there are risks with a VBAC, but there are also dangers to both mothers and infants associated with a repeat cesarean, and particularly multiple repeat cesareans. Once you have that first cesarean, your risks during any type of subsequent delivery go up. We should also work to reduce unnecessary cesarean sections.”
• A just-released study shows that the newborn death rate in low-risk women is lower for those born by VBAC than those born by repeat cesarean
• Two studies, one done in 2008 and another in 2006, show that women who undergo repeat VBACs suffer fewer complications than women who undergo repeat cesareans, and babies fare increasingly better with each subsequent VBAC delivery
• A study from February 2010 challenged the conventional wisdom that women with multiple prior cesareans should not be allowed to attempt VBAC, and showed that VBAC outcomes for mothers with three or more prior cesareans are as good as outcomes for women who only had one prior cesarean
Cumulatively, these and other studies demonstrate that while VBAC carries risk, for most women it is likely the healthier choice for herself and her baby. The potential for problems in both mother and baby decrease with every VBAC and increase with every cesarean…

Blogger Labels: VBAC,Women,Babies,Lamaze International,National Institutes of Health,complication,malpractice,newborn,death,controversies,lawsuits,infants,complications,cesarean,cesareans

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