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Source: ONE News -
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Having a normal vaginal birth after previous babies were
delivered surgically is perfectly safe and women should have the
option, independent experts told the US National Institutes of
Health.
They said there is no good reason to force a woman who has had one
Caesarean section to repeat such operations if she wants to try
having later babies more naturally.
The experts cited rigorous research showing that at least trying
natural labour is successful in nearly 75% of cases, and women are
less likely to die if they are allowed to labour naturally for a
while, even if they end up delivering surgically.
"Declining vaginal birth after Caesarean rates and increasing
Caesarean delivery rates over the last 15 years would seem to
indicate that planned repeat Caesarean delivery is preferable to a
trial of labour," Dr F Gary Cunningham, chairman of the NIH expert
panel, said in a statement.
"But the currently available evidence suggests a very different
picture: a trial of labour is worth considering and may be
preferable for many women," added Cunningham, the chairman of
obstetrics and gynaecology at the University of Texas Southwestern
Medical Center at Dallas.
The panel cited two recent surveys of hospital administrators that
showed 30% of hospitals had stopped offering women the option of
trying labour if they had undergone one Caesarean.
Some doctors fear that the incisions from the first operation
could burst open during the pressure of contractions, endangering
mother and baby.
But studies have shown the rate of rupture is less than one
percent.
The American College of Obstetrics and Gynecology does not
recommend vaginal delivery for women who have had three or more
C-sections.
Rates of Caesarean sections have risen steadily in the United
States, from 20.7% of births in 1996 to 31.1% in 2006.
And nearly 40% of the Caesareans performed in the United States
each year involve women who have had previous C-sections.
The issue has become controversial, with some lobby groups pressing
hard for women to be given the option of having vaginal birth after
Caesarean, or VBAC.
"There's still a lot we don't know about which women will be
successful in having a VBAC, but we believe it's essential that
women's desires and preferences be respected throughout the
decision-making process," Cunningham said.
