Saturday, October 18, 2008

Meta-analysis Shows VBAC Improves Outcomes over Repeat Elective Cesarean Section



Maternal Morbidity following a Trial of Labor after Cesarean Section vs Elective Repeat Cesarean Delivery: a Systematic Review with Meta-analysis


A new meta-analysis showed that while VBAC carries a greater, although still low risk (1.3%) of uterine rupture/dehiscence than repeat elective cesarean section, the risk is counterbalanced by lowered rates of maternal morbidity, uterine rupture/dehiscence and hysterectomy with successful VBACs.


The research also showed that the majority of women who attempted VBAC were successful (73%).


I have to wonder how much higher that number would be if women had true access to an evidence-based approach to childbirth without unnecessary interventions, and truely supportive providers.


Regardless, the evidence continues to overwhelm with support that VBAC should be a viable option in the majority of cases and that repeat elective cesarean section carries risks greater than or equal to VBAC.


It's time to lay the "once a c-section, always a c-section" myth to rest. Period.

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