The major medical organization representing obstetricians said Wednesday that a vaginal birth after caesarean is a safe and appropriate choice for most women who have had a prior C-section, including some women who have had two prior C-sections.
The guidelines were issued by the American College of Obstetricians and Gynecologists. Hospital policies, legal concerns, insurance restrictions and factors related to doctor and patient convenience often prevent women who could have a VBAC from getting one. "Moving forward, we need to work collaboratively with our patients and our colleagues, hospitals and insurers to swing the pendulum back to fewer caesareans and a more reasonable VBAC rate," Dr. Richard N. Waldman, president of ACOG, said in a news release.
The guidelines follow the release in March of a report from a National Institutes of Health advisory panel calling for an easing of restrictions surrounding VBAC. That panel concluded that there are risks and benefits to VBAC and that women should be fully informed of their options and allowed to make a choice.
Almost one-third of all U.S. births today are by caesarean section. Two decades ago, one-quarter of U.S. women who had a previous caesarean attempted a VBAC in a subsequent pregnancy. But that rate has fallen in 9%.