Government Panel Questions 'VBAC Bans'

Filed under: In The News


The National Institutes of Health convened an independent panel this week to re-evaluate so-called bans on VBACs, or vaginal births after cesareans. Many women who have had cesareans currently are not offered the VBAC option, even if they are at low risk for complications.

"Declining VBAC rates and increasing cesarean delivery rates over the last 15 years would seem to indicate that planned repeat cesarean delivery is preferable to a trial of labor. But the currently available evidence suggests a very different picture: a trial of labor is worth considering and may be preferable for many women," says Dr. F. Gary Cunningham, chair of the 15-member panel, in an NIH press release.

The panel also advocates revisiting current VBAC guidelines, addressing malpractice concerns and conducting additional research on the factors that influence how a woman with a previous cesarean will deliver.

Before a 1980 consensus statement, it was widely believed that women who had a cesarean delivery would have to deliver subsequent pregnancies via cesarean. VBAC rates then went up until 1996, but then declined again. The current VBAC rate is 10 percent, compared to 28 percent in 1996.

"There's still a lot we don't know about which women will be successful in having a VBAC, but we believe it's essential that women's desires and preferences be respected throughout the decision-making process," says Cunningham, who is also chair of obstetrics and gynecology at the University of Texas Southwestern Medical Center at Dallas.

Related:
Vaginal Birth After Cesarean

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Start by teaching him that it is safe to do so.