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July 28, 2010 | Print

New VBAC Guidelines Are Less Restrictive

The American College of Obstetricians and Gynecologists (ACOG) has released new guidelines for vaginal deliveries after a cesarean section (VBAC) stating that vaginal birth is a “safe and appropriate choice” for women who have had a cesarean delivery in the past, and for some women who have had two previous cesarean deliveries.

The new guidelines are in response to ACOG’s former guidelines which led many hospitals and doctors to limit VBACs, or refuse to allow them, for fear of liability if they did not follow ACOG’s more stringent recommendations. The former guidelines were interpreted by some health care providers as requiring a surgeon and anesthesiologist to be at the hospital at all hours, and even the presence of two doctors during a VBAC. Cesarean rates have increased to reach 31% in 2007, an alarming number that obstetricians are working to reduce for the health of mothers and their babies. ACOG now recommends that early in their pregnancies women discuss the risks and benefits of VBAC and potential complications from repeat cesareans. They do not want hospital restrictions to dictate that a woman have another cesarean if she prefers a vaginal delivery.

The guidelines are a positive step. They give women, their doctors and midwives an opportunity to talk in more detail about labor and delivery, and empower women to participate in making decisions about their health.

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