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ACOG issues less-restrictive guidelines for VBACs
NEWS IN BRIEF — Posted Aug. 2, 2010
Attempting a vaginal birth after a previous cesarean (VBAC) delivery is safe and appropriate for most women, say guidelines by the American College of Obstetricians and Gynecologists.
The new recommendations, in the August Obstetrics & Gynecology, update guidelines issued in 2004. They state that women with two previous low-transverse cesarean incisions, women carrying twins and women with an unknown type of uterine scar are considered appropriate candidates for a trial of labor after a previous cesarean delivery (link).
The latest guidelines aim to lower the country's cesarean delivery rate, which climbed from 5% in 1970 to more than 31% in 2007. ACOG estimates that 60% to 80% of appropriate candidates who attempt a VBAC will be successful. However, in determining a birth plan for that group of women, the college encourages physicians to consider a woman's chance of a successful vaginal birth and the risk of complications from labor.
Potential complications from repeat cesareans and labor include maternal hemorrhage, infection, operative injury, blood clots, hysterectomy and death. Doctors uncomfortable with a patient's desire to undergo a VBAC should refer her to another physician or center.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2010/08/02/prbf0802.htm.
