Sunday, May 22, 2011

Why I believe it is safer to have a vaginal birth than a repeat c-section...

Research consistently reassures me that VBAC (vaginal birth after cesarean) is safer than a repeated cesarean.  Common sense tells me that natural is better than surgical birth. Unfortunately, VBAC is not the accepted medial norm at this time (at least not where I live in North Carolina.)  Many women who have had a c-section once are urged by their doctor to schedule a repeat c-section for baby #2.  The problem is that with each subsequent pregnancy, c-sections become riskier and riskier.  To me, the risk associated with this major abdominal surgery for death does not seem worth it.  There is some research that if mom goes into labor and attempts to have a VBAC but ends up with emergency c-section, her risk is higher than scheduling the c-section before labor (2).  But, the most recent literature that I've seen shows that overall, going for the VBAC is safer than the scheduled repeated c-section (1). Click the links below to find more information on this topic.

1. Canadian Medical Association Journal. 2007 Feb 13; 176(4)

2. American Journal of Obstetric Gynecology. 2001 Jun; 184(7):1365-71

3. International Cesarean Awareness Network

Here are some excerpts from the article "Maternal Mortality Rates Rising in California" published March 4, 2010 on the website for ABC Worldnews with Diane Sawyer at
     "According to the World Health Organization, the U.S. ranks behind more than 40 other countries when it comes to maternal death rates, with 11 deaths per 100,000 pregnancies when measured in 2005. More women die in the U.S. after giving birth than die in countries including Poland, Croatia, Italy and Canada, to name a few."
    "Doctors say it's hard to pinpoint exactly why the numbers are rising. Experts have cited the growing number of obese mothers as a big factor -- 20 percent of all pregnant women in the U.S. are now obese at the start of their pregnancy, according to the Centers for Disease Control. These women are more likely to have underlying health conditions, including diabetes or asthma, which can lead to pregnancy-related complications.
     "The popularity of scheduled C-sections has also been cited by public health experts as a possible cause for rising maternal mortality rates. The latest data from the CDC shows that 31 percent of the mothers now choose to have C-sections, up 50 percent since 1996. Studies have repeatedly shown a higher rate of mortality in mothers who have a C-section delivery, especially those who have multiple C-sections.
'If the risks of a Cesarean birth are small, they're magnified greatly when you add many more Cesarean births each year," said Main, adding that "not that many women actually choose to have an elective C-section at the beginning, but it's easy to fall into a pattern of care that ends up resulting in a C-section.'
And, finally, a beautiful You-tube video about one mom's experience with a c-section then successful vaginal birth after cesarean:

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