WOMEN'S HEALTH
November 28, 2013

C-Section Not Required

Women who had a C-section with their first child often are successful giving birth vaginally for the next.

Women who gave birth to their first child via Caesarean section often face a difficult decision when they are pregnant with their second child: should they attempt a vaginal delivery this time around? A new British study may help them decide — over 60 percent of women who attempt a vaginal birth after Caesarean, or VBAC, are successful.

Researchers looked at who was most likely to attempt a VBAC and the factors that determined if it was successful. Using data from 143,970 women who gave birth to their first child by Caesarean section, they found that just over half of the women attempted a vaginal birth with their second child.

Pregnant women who have had a Caesarean section for their first pregnancy and uncomplicated healthy second pregnancy should be given the option of VBAC for their next baby.

Women 24 years old or younger were more likely to attempt VBAC than women 34 years old or older, 60 percent versus 45 percent respectively. Asian (64 percent) and black women (62 percent) were also more likely to attempt VBAC, compared to white women (49 percent).

Black women had a lower VBAC success rate (50 percent) than white women (66 percent), as did women 34 years old and older (59 percent) compared to women 24 years old and younger (69 percent).

Not surprisingly, women whose first baby was delivered by emergency C-section, and those who had a failed induction of labor, were less likely to have a successful vaginal birth attempt for their second child.

Incision Decisions
Caesarian birth is surgery. It involves anesthesia and generally a much longer recovery period. Should more women attempt VBAC? Hannah Knight, lead researcher of the paper, thinks they should: “The majority of women with an uncomplicated first Caesarean section are candidates for attempting VBAC, but our data found that only half of those women chose this option.”

John Thorp, deputy editor-in-chief of the British journal publishing the study, notes that according to current U.K. guidelines, pregnant women who have had a Caesarean section for their first pregnancy and uncomplicated healthy second pregnancy should be given the option of VBAC for their next baby.

Before an electing to have another C-section women should sit down with their obstetrician or midwife and talk about the risks and benefits of the two options.

According to current U.S. guidelines, which were updated in 2010, women who have had one previous C-section and a low abdominal incision can be offered the option of VBAC.

The study is published in the BJOG: An International Journal of Obstetrics and Gynaecology.

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