Sunday, September 18, 2011

Vaginal Birth a Safe Option After *Multiple* Cesareans

When you understand the actual statistical risks associated with a VBAMC (vaginal birth after multiple cesareans), you understand that the risk is really very small in terms of uterine rupture. Because of my personal history with VBAC'ing, it frustrates me when care providers of all types are afraid of rupture. They obviously haven't done the research, because if they had they would understand that the risk is just as low as other birth emergencies (such as cord prolapse). There are emergencies that can come up in *any* labor and birth, which is why it is important for care providers of all types to be prepared. But to be scared of VBAMC? It's just not evidence based fear.

Dr. Mark Landon has done multiple studies on vaginal birth after multiple cesareans, showing a risk of 0.9% for rupture in women who have had multiple prior cesarean sections.

You can read the bulletin here , and here is a quote from it:

Landon found that the risk of uterine rupture was 0.9 percent in cases of women with a history of multiple prior cesarean deliveries undergoing a trial of labor, compared with 0.7 percent in the cases of patients who had experienced only one previous cesarean delivery. These data challenge the notion that women with more than one prior cesarean are at dramatically increased risk for uterine rupture with a VBAC attempt.

“We looked at the outcomes associated with uterine rupture, including catastrophic outcomes such as stillbirth, or hypoxic brain injury to the baby,” says Landon. “And the good news is that the vast majority of uterine ruptures fortunately are associated with healthy infants. The absolute risk of catastrophic rupture with poor outcome is, in fact, quite small.”

So ladies - take heart! Not only is a vaginal birth POSSIBLE after multiple cesareans, it is also considered safe. Don't take no for an answer. If you are told no, if you are told that you don't care about your baby's life, if you are told that you will kill your baby ... find another care provider.

And here is a YouTube slide show of VBAMC to enjoy. :)

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