LOS ANGELES — Vaginal birth after Caesarean, or VBAC, is reasonably safe
and should be more widely available, a National Institutes of Health advisory
panel concluded Wednesday.
Such deliveries once accounted for 25 percent of U.S. births among women with a
previous Caesarean delivery but have now fallen to less than 9 percent. Many
women would like to attempt a vaginal delivery, however, and the consensus
statement is expected to increase their access to the option.
The NIH panel, composed of independent experts in maternal and child health,
found that, although both VBAC and a planned, repeat Caesarean pose a range of
risks and benefits, women should be allowed more choice. Thus, nonmedical
deterrents such as hospital policies, legal liability concerns and doctor
preferences should be dismantled, it stated.
"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,
nonprofit organization that works to improve maternity care. "They want to give
women the option of VBAC."
The statement was released at the conclusion of a three-day meeting convened in
Bethesda, Md., to reassess the scientific evidence on VBAC safety, taking into
account women's and doctors' attitudes.
The U.S. Caesarean delivery rate has risen 50 percent since 1996 and now stands
at a record high of 31.8 percent of all births, and a policy of repeating
Caesareans once a woman has had one has contributed significantly to that climb.
Federal health authorities have suggested the primary C-section rate should be
about half of what it is now.
VBAC fell out of favor over the last 15 years because of criticism that it was
performed too often, especially among women at high risk for complications. The
most serious risk of VBAC is that the uterus will tear along the scar left by
the previous Caesarean delivery. A uterine rupture, which occurs in about 0.8
percent of women having their first VBAC, can be life-threatening.
Source : STLtoday.com
