New VBAC Guidelines Give Women More Decision-Making Power, Editorial States

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The title's enough to cause concern! Women always have decision-making power over their own bodies.

Although it is "understandable" that some health care providers are "cautious" about vaginal births after caesarean sections, it "should hardly be a controversial notion" that a woman who has had a c-section "should have a say in whether to try a vaginal birth during her next delivery," ...

... one-third of U.S. hospitals and 50% of physicians refuse to allow women to attempt VBACs "due to a fear of lawsuits over uterine ruptures," which occur in 0.7% to 0.9% of cases ... "Extremely small as that risk may be, even tiny numbers represent real women and real babies who can suffer serious consequences in a delivery gone bad," ...

Sydney has the same situation, with some smaller hospitals not allowing VBACs owing to lack of 24/7 theatre facilities.

However, "when up to 80% of women who are 'allowed' to attempt VBAC succeed, it's not so easy to understand why all women aren't 'allowed' to weigh the risks and to make their own choices regarding their own childbirth experiences," ... The American College of Obstetricians and Gynecologists " recently eased its guidelines to say that hospitals offering women trial labors after caesareans should have a surgical team 'readily available' instead of 'immediately available,'" ...

"It's a small change, but one that might send the precipitously declining VBAC rates headed in the right direction again," the editorial argues, concluding, "Let these new guidelines be the impetus for giving women the information they need to weigh the risks and to be able to choose a trial labor or a repeat caesarean themselves"

Given the risks of repeat caesareans, particularly for women who have multiple caesareans, VBAC ought to be encouraged for most women. We also need to focus on woman-friendly care in pregnancy and labour; care that affirms the woman's belief in her ability to birth her baby and care that is sensitive and individualised.

Melissa Maimann, Essential Birth Consulting 0400 418 448