RIP VBAC?

Malpractice fears has already decimated the VBAC (vaginal birth after C-section) in the US. This study isn’t going to help things:

A Caesarean section increases the risk by 50-fold that a woman’s uterus will rupture during a subsequent vaginal delivery, research suggests.
A torn uterus can put the life of both the mother and baby in danger.
US and Swedish researchers found the condition afflicted nine in every 1,000 mothers who opted to try for a vaginal birth after a previous Caesarean.
In contrast, the BJOG study found the rate among women with no history of a Caesarean was just 0.18 per 1,000.

Comments

Anonymous
The VBAC may be dead because of the modest, but real risk of death associated with it. I’m a believer that a truely informed ‘informed consent’ should about cover all outcomes. (unfortunately, people who do have the outcome that they didn’t like but yet selected for themselves will seek to have a change of heart for their day in court).
Since most women who get their first C section are not fully appraised of the near absolute need for subsequent C section, we could lower the section rate by suing it into oblivion.
Eileen Sullivan
You’ve got to be kidding me. Did you seriously expect the “findings” of this study to be any different?! While we’re at it, why don’t we do a study to determine if people with HIV are more at risk of developing AIDS. Of COURSE women who’ve never had a cesarean are much less likely to experience a uterine rupture. All the more reason not to go around slicing women’s uteri to deliver their babies!
Meanwhile, you seem to have missed the important parts of the article. A rupture rate of nine in 1000 is still LESS THAN ONE PERCENT. In other words, more than 99% of the time, women attempting to VBAC will NOT experience a uterine rupture. The medical profession as a whole does a lot of procedures that are far more risky, and no one thinks to limit you to things that are more than 99% safe.
But let a woman want to VBAC and all hell breaks loose. Clearly, risk management and defensive medicine have a lot to answer for. Talk about seriously limiting a woman’s choices. Worse, the media has jumped on the bandwagon and is fully assisting. Seems like every report I’ve seen on this BJOG article is dedicated to fear-mongering, rather than balanced reporting of the facts. I hope women will read between the lines, but there’s no doubt that the medical profession and news services together are making that very hard to do.
I would’ve hoped that someone with your background would more thoroughly read and understand the research being presented. But I guess the Chicken Little approach to VBAC is the party line these days, for M.D.s of all types. Never mind the facts: “the sky is falling!” You’ll pardon me if I don’t join you in running for cover.
Eileen Sullivan
(My qualifications? I can read.)
Anonymous
Why does the rate of rupture for a non-C patient get an actual stat percentage (.18) but the rupture in a prior c/s patient does not. You specificially point out the 9 in 1,000 but give no actual stat percentage on that one (still less than 1%)
Yet another fear mongering tactic to scare women.

RIP VBAC?

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