Second cesarean safer than VBAC

NEWS IN BRIEF — Posted Jan. 17, 2005

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Attempting a vaginal delivery after a cesarean puts the woman at increased risk of uterine rupture or endometritis but has no impact on the rate of maternal death or hysterectomy, according to a paper in the Dec. 16, 2004, New England Journal of Medicine.

Researchers at 19 academic health centers participating in a study funded by the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network prospectively observed more than 30,000 women over four years who had delivered initially by cesarean. More than 15,000 decided to have a cesarean for their subsequent births; more than 17,000 attempted to deliver vaginally. Of these, just under 1% had a uterine rupture. Nearly 3% developed endometritis, while just under 2% of those who had a second cesarean did.

The authors concluded that VBAC is riskier than a second cesarean, though the absolute risks are low.

"While the magnitude of these risks for serious complications is small, women who have had previous cesarean section and who are considering choices for childbirth should be aware of the level of risk involved," said Mark Landon, MD, lead author and vice chair of obstetrics and gynecology at the Ohio State University Medical Center in Columbus.

Note: This item originally appeared at

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn