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Health & Pregnancy

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New Guidelines for Women With Prior Cesareans

Ob-Gyns Make Guidelines Less Restrictive for Vaginal Birth After Cesarean, or VBAC

New VBAC Guidelines: Other Opinions continued...

"Based on this extensive evidence, a trial of labor is a reasonably safe procedure [after C-section] as long as safety guidelines are followed," he says. That means choosing the right patient, he says, as well as the right baby and having the optimal setting in terms of staff and support.

"There are slightly increased risks of complications with a trial of labor after C-section, and these could be offset by careful monitoring."

The new guidelines got a favorable response from the International Cesarean Awareness Network (ICAN). In a statement, ICAN's president, Desirre Andrews, says: "ACOG's updated recommendation for VBAC are much more in line with the published medical research and echo what ICAN has stated for years. Less restrictive access to VBAC will lead to lower risks to mothers and babies from accumulating cesareans."

But the health care environment may need to catch up with the guidelines, according to ICAN. In a 2009 survey of more than 2,800 hospitals, ICAN found that 30% had formal policies forbidding VBAC and 20% had no doctors on staff willing to accept a woman planning VBAC.

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