Much controversy surrounds VBAC (vaginal birth after cesarean) today. With an all-time high cesarean section rate of 31.1% nationwide (in 1996, section rates were 14.6%), VBACs are definitely a hot topic. In the 80's and 90's, VBACs occurred at a tremendous rate. Then, true to obstetrical history (where practices are often implemented without adequate research), research was started on this practice. A disturbing trend of complications became apparent, specifically uterine rupture. The VBAC then almost went the way of the albatross, nearly becoming extinct. Doctors and hospitals across the country stopped offering VBACs as an alternative to repeat cesareans due to safety and liability issues.
Uterine rupture is catastrophic if it occurs. It can result in fetal and maternal damage or death. However, the early stages of research included women who had one or more sections, women being induced with prostaglandins (cytotec, cervidil, etc) and/or pitocin. So trully the early research was not an accurate picture of the risk of VBAC. Again, true to obstetrical history, everyone jumped on the bandwagon and stopped offering VBACs.
In the past few years, research has been refined and continues to be improved upon in this area. Now, research tells us that women can safely and effectively VBAC when certain criteria is met. Recently, Obstetrics & Gynecology released a study that yet again found positive outcomes associated with VBACs and negative outcomes associated with elective cesarean. This journal is also known as the 'green journal', and is associated with the American College of Obstetricians and Gynecologists (ACOG).
So research shows us that women having elective repeat cesareans are more likely to have infants with respiratory distress, have less children than women having vaginal deliveries, increased risk of stillbirth, increased risk of placental abnormalities in future pregnancies...not to mention all the risks of having major abdominal surgery (infection, hemorrhage, damage to organs, death). And this is just a brief overview!
For more information regarding cesarean sections and VBACs, check out these links...
Childbirth Connection - Cesarean Sections
Childbirth Connection - VBAC versus Repeat C/S
Navelgazing Midwife
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