Good news for moms-to-be contemplating vaginal birth after Cesarean (VBAC): According to a relaxed set of new guidelines released July 21, 2010, from the American College of Obstetricians and Gynecologists (ACOG), attempting a VBAC is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous Cesareans. The decision to endorse VBAC as a safe birthing choice for most women comes as a result of recent studies showing relatively low risk for uterine rupture and other complications.
Approximately 60 to 80 percent of candidates who attempt VBAC will be successful, says ACOG. And, as the new guidelines point out, VBAC avoids major abdominal surgery, lowers a woman's risk of hemorrhage and infection, and shortens postpartum recovery. It may also help women avoid the possible future risks of having multiple Cesareans such as hysterectomy, bowel and bladder injury, transfusion, infection, and abnormal placenta conditions (placenta previa and placenta accreta).
Is VBAC for you? According to Dr. Jeffrey L. Ecker, coauthor of the new guidelines, "when making plans for delivery, physicians and patients should consider a woman's chance of a successful VBAC as well as the risk of complications from a trial of labor." Having certain complications, such as gestational diabetes or preeclampsia, may make Cesarean the safer choice for both Mom and Baby.
As Dr. William A. Grobman from Northwestern University in Chicago, another guideline coauthor recommends, "It is absolutely critical that a woman and her physician discuss VBAC early in the prenatal care period so that logistical plans can be made well in advance."