Delivery Room: New Guidelines Okay Vaginal Birth After C-Section

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By Mia Bolaris-Forget

Women who in the past gave birth via c-section had little or no hope of ever giving birth "naturally" (or vaginally). But now new guidelines may change all that.

Recently leading obstetric professionals loosened the guidelines and published a report that may allow more vaginal births after c-sections....known as VBACs.

The new guidelines suggest that a trial of labor is a reasonable and appropriate option for many ladies who've previously delivered via c-section, including women who've had two prior c-sections or who are carrying twins.

According to statistics, the number of women who deliver vaginally following a c-section had dropped significantly since the late 1990s (1996 to be exact). 1996 stats show vaginal births after c-section to be at 28% while 2006 statistics show the number to be at only 8%; this, despite studies that show that 60% to 80% of women who are ideal candidates for vaginal births after c-section will succeed if they try.

In addition, the numbers show that the overall rate for c-section delivery has gone up and hit an all-time peak of more than 31% in 2007 (the latest data available to date). And, many pros "blame' the previously instated guidelines.

In the past, the OB-GYN group recommended that only hospital facilities with a "readily available" surgical team-----translated into a facility that was no more than a half-hour drive away, allow vaginal births after c-section. However the 1999 guidelines called for an "immediately available" surgical team just in case of "problems" such as a rupture, uterine tear, or the rare need for an emergency c-section.

According the industry professionals this means have an anesthesiologist and an open room ready to go if a patient should need it...and many "fear" not being able to meet these guidelines...and leaving themselves open for lawsuits should something go "not as planned" during a VBAC attempt.

Yet, while the VBAC guidelines recommend an "immediately available" on-hand surgical team, supporting information regarding its benefits is still not clear. In fact, those who say it's okay for most women to undergo a VBAC also note that while there is some risk to not having a surgical team immediately ready, the risk is not very large. And, they add that the new documentation clearly stated that no one should be coerced into having a c-section delivery.

Debra Bingham, president elect of Lamaze, a not for profit that pushes for a health, natural, and safe approach to childbirths notes that the new guidelines are "a step in the right direction". However, she adds that there is still some concern that the phrase "immediately available" are still part of the document.

Other professionals such as Mark Landon, chairman of OB-GYN at the Ohio State University and lead scientist for NIH sponsored research noted his support of the new guidelines and the emphasis on sending women wanting a VBAC to facilities willing to accommodate them. The "problem" however, as he sees it, is that not many are willing to do so.

Long Island Pregnancy Articles > Delivery Room: New Guidelines Okay Vaginal Birth After C-Section