A reader sent me an article and a report last week that she thought I would find interesting. She was right.
The Irish Times article, Delivering real choice after a Caesarean, spotlighted the VBAC situation in Ireland.
In fact, women who go into spontaneous labour after one previous section have about 80 per cent chance of vaginal delivery, says Dr Peter Boylan of the National Maternity Hospital, which has one of the highest VBAC rates in the country.
“When a woman has an unhappy experience with a first labour, she does not want to repeat the experience. That is very understandable. But what we always say to women is that was a unique experience – you can only have your first baby once.”
As the second pregnancy progresses, inevitably the memories flood back and they get extremely anxious. They are assured the same thing won’t happen.
“If they come in in labour, then decisions will be made an awful lot quicker. Instead of 10 or 12 hours in labour, a decision will be made within three or four hours.
“Also, if they are overdue, any attempt at induction will be a lot shorter, whereas in a first birth, because the uterus is intact, an induction could go on for three days because there is no risk to the mother. Whereas if she had a section before, then we are a lot more cautious.
“Women who have had a normal birth and then a section can never understand why somebody would elect for a section,” he says.
“The majority of women who have had a section and then a normal birth say, ‘I am glad I did that’.”
A paper published in August 2009 by the Economic and Social Research Institute, Recent Trends in the Caesarean Section Rate in Ireland 1999-2006, documented a 25.5% cesarean rate in Ireland as of 2006 and, as the reader who sent me this pointed out, found that “at least half of the rise in c-section rates is due to ‘changes in physician behaviour’ not older mothers or other risk factors.”