Vaginal Birth After Cesarian Safer than Thought

A new study involving 19 academic centers and 46,000 women has demonstrated that while serious complications are possible in giving vaginal birth after a cesarean-section birth, the absolute risk of these occurring is very small.

For years, doctors recommended that women who delivered via cesarean section should not deliver future infants vaginally, but studies over the past 20 years disputed that belief and many women have chosen to undergo vaginal birth after cesarean section (VBAC). While this new four-year study shows that women attempting VBAC are at increased risk for maternal morbidity and serious obstetric complications, such as uterine rupture, endometritis, transfusion, or newborn hypoxic ischemic encephalopathy, the risks are small.

"While the magnitude of these risks is small, women who have had a previous cesarean section and who are considering choices for childbirth should be aware of the level of risk involved,” said principal investigator Dr. Mark Landon, vice chairman of obstetrics and gynecology at the Ohio State University Medical Center (Columbus, USA). "Overall, the risk for a serious newborn complication is approximately one in 2,000 trials of labor. At this level of risk, many women will continue to opt for an attempted VBAC.”

The overall rate of cesarean delivery has risen in the United States from 5% in 1970 to 26.1% in 2002. The rate of VBAC has increased 10-fold, from 3% in 1981 to 31% in 1998.



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Ohio State University Medical Center