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Thursday
Feb042010

Quick Hit: New Research on Safety of VBA3C

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From Medical News Today:

Do We Need To Revisit VBAC Guidelines For Women With Three Or More Prior Caesareans?

New research to be published in BJOG: An International Journal of Obstetrics and Gynaecology has found that women with three or more prior caesareans who attempt vaginal birth have similar rates of success and risk for maternal morbidity as those with one prior caesarean, and similar overall morbidity (adding vaginal births and emergency caesareans together) as those delivered by elective repeat caesarean.

[…]

Lead author, Dr. Alison Cahill, from the Department of Obstetrics and Gynaecology at Washington University in St. Louis School of Medicine, said “These data suggest that women with three or more prior caesareans who attempt VBAC have similar rates of success and risk for maternal morbidity as those with one or two prior caesareans, and along with other publications, suggest that perhaps it is time to revisit the current recommendations for VBAC attempts for women with more than one prior caesarean”.

 

 

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Reader Comments (6)

About two years ago, a woman came to my now defunct ICAN chapter desiring a VBAC. She'd had three sections for various unrelated reasons and one vaginal stillbirth, not full-term. Told her doc she wanted a VBAC, he was skeptical but told her he'd help her out.

Somewhere along the way, right at the very end, he threw her under a bus. A meeting was called between the mom, her OB, the chief OB of the hospital and the hospital Chief of Staff. I was asked by the mom to come along too, so armed with research and numbers, I went.

The reason I tell this story is to tell you this: those doctors simply did not care about all the supportive data in the world. They treaded very close to the line by telling her "we could call the police, we could hold a gun to your head", but never actually said they "wouldn't" allow her to have her VBA3C, but when I countered the chief OB's claims (direct from ACOG's guidelines, of course), I was blown off and told "those are just numbers" and things like, "when happens to a real woman, the risk is 100% to her." Landon, Miller, whomever... these guys just don't want to hear it.

Call me cynical - I just don't feel like anything as "trivial" as, say, research, is enough incentive to open doors for women who have the audacity to want an informed choice.

February 5, 2010 | Unregistered CommenterRachel z

The one thing these latest conversations fail to mention is the rise in risks due to induction or augmentation of labor. As long as you don't try to induce or augment a VBAC mom the risks are really quite low for Uterine rupture -- less than 1%.

February 5, 2010 | Unregistered CommenterAmy V. Haas, BCCE

Rachel, that was my experience. They had their mind made up that a baby with an estimated weight of 900g below the 5000g threshold for elective cesarean was going to be sectioned and they weren't going to let evidence get in the way.

The problem, of course, is that doctors are simultaneously weighing a different set of risks unbeknowst to most patients. We trust our doctors to provide us with care that is in our best interest, but we don't realize that they are also working hard to make sure that it works out in their best interest (and the hospital's) as well.

February 5, 2010 | Registered CommenterJill

Amy, that's true. I rarely see a mainstream article that mentions the risk of induction/augmentation in VBAC.

February 5, 2010 | Registered CommenterJill

rachel z,
not sure where you are from but im in sydney australia. i have just had a meeting with the head doc at my local hospital regarding my vbac3 and after showing him all of my research he said to me the exact same words he said to you and your friend.. it must be a trained reponse from them samethinh they learn in med school. after continuing my debate with him he finely agreed that i was right and the risk were actualy really low and is now doing what he can to help me..(although still not real happy about it!!!)...

February 5, 2010 | Unregistered Commentercassandra

Cassandra
hun what hospital are you attending for your VBA3C??? I want a VBA3C and i am desperatly doing all my research now......

You can email me privatly or on here is fine :)

Kathryne

September 24, 2010 | Unregistered CommenterKathryne
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