New, Less Restrictive VBAC Guidelines

Please welcome a new contributor who’ll be sharing her brilliant mind with us every so often here on The Shopping Mama. Malia is a fellow Air Force mom who recently moved to Florida (near me!). She blogs at The Jack Effect, a blog about babies, cloth diapering and all that her young son brings. Please welcome her, chime in here and check out her blog (where you can find a more in-depth post on the new VBAC guidelines).

***

Like a lot of women, when I reached month seven or so of my pregnancy I started to consider how the little guy was going to get from point A (my tummy) to point B (my arms). The doctor thought there was a chance I would need a c-section if he was a big baby, so a c-section was definitely on my radar. I wasn’t excited about the idea, but I was open to whatever needed to happen for a healthy baby. By the end I was ready to just schedule an appointment and get my baby out whatever it took! After 12 hours of labor and an amazing nurse and doctor I got my baby and no c-section. It wasn’t until I was home recovering that I realized how blessed I was to have a vaginal birth.

Not every mama gets the chance to have a vaginal birth when she hopes. For thirty-one percent of women in the US the end result of pregnancy is a c-section (in 2007). For some this is their birth plan and what they wanted or needed for their own or their baby’s health. For others it is a disappointment, an ending not at all in their birth plan. For these women, a recent update to the Vaginal Birth After C-Section (VBAC) guidelines published by The American Congress of Obstetricians and Gynecologists (ACOG) may be welcome news.

New ACOG Guidelines on VBACS

ACOG’s newest guidelines stress that VBACs should be an option for most women including those with one or two prior c-sections, carrying twins, or arriving to deliver where an emergency surgical team in not immediately available (such as a small hospital).

ACOG has put the emphasis back on mom’s choice—as long as it’s an informed one.

ACOG hopes their new guidelines will help reduce the number of c-sections over all. In the 70’s our mothers helped make VBACs more commonly accepted and VBAC rates rose until the mid 90’s. Then, in the past half a decade, there has been a dramatic decline in VBACs. This decline has been linked to restrictions from insurers and hospitals afraid of being sued and decisions made by moms worried about the risks of VBAC. Pregnant women and doctors are worried that the surgical scars from a c-section could increase the risk of uterine rupture and bleeding, something that can be extremely dangerous for both mom and baby. Additionally, while a vaginal delivery after a c-section has been shown to be safer than a repeat c-section, a c-section after a failed VBAC is more dangerous than a scheduled c-section. It may help women to know that ACOG has found that there is less than a 1% increase in uterine rupture in VBACs and that the majority (60-80%) of women trying for vaginal birth after c-section succeed. I’m not sure I would be willing to take the risk, but I’ve never dealt with c-section recovery.

What do you think? Would you consider a VBAC? Do the new guidelines change your opinion?

{image via asterisc21}