Local Woman Seeks VBA3C

I came across this video on the main ICAN blog page. It is about a local woman who has had 3 previous cesareans and is pregnant again. This time she would like the opportunity to try for a vaginal labor. Unfortunately she has been denied care by physicians due to the previous cesareans. Whether it is three previous cesareans or one, this is a critical issue for many women throughout the United States.

So what does the research say about the risk of vaginal birth after cesarean? Well, research points to a less than 1% risk in women with primary cesareans with a lower segment transverse uterine incision and a 1%-7% risk for women with a lower vertical incision and a 4%-9% risk with women who have had the extremely rare "T" or "J" incision. Given that most women of childbearing age have a lower segment transverse incision or "bikini cut", this is a very small risk. And though the incidence of uterine rupture does increase with multiple cesareans, it is still a minimal precentage of births that result in uterine rupture. Another side to look at is increased risk of rupture with induction. Research has shown that induction is not safe or indicated for the majortiy of vaginal births after cesarean, but it is still used because of fear of stillbirth or rupture.

So despite the evidence that each mother should be allowed at least a "trial of labor" when uterine rupture is less than 1% and the sucess rate of vaginal birth after cesarean should be 85%, why are more mothers not allowed to at least attempt a vaginal birth after cesarean? As the mother in the video states, many doctors are fearful of litigation. There is an unspoken understanding in the medical community that you will not be faulted for a cesarean section. It is a shame that such fear leads to extreme measures like major abdominal surgery without true medical indication.