Vaginal Birth After Cesarean: Risk Assessmnet and Current Practices

Abstract

Many women believe that having a vaginal delivery after a cesarean is very dangerous or could even be life threatening. Often doctors are not willing to discuss vaginal birth after cesarean with their patients because they believe the same. Vaginal births after cesarean (VBAC) in the United States have decreased at a rate from 35.3% in 1997 to 8.2% in 2007 (Cox, 2011). Controversy surrounds VBAC because of the increased risk of complications and uterine rupture. However, repeated cesarean birth is associated with its own set of increased risks including damage to the bladder and bowels (Dodd et al, 2009). Providers are currently reluctant to perform VBAC because of liability risks and the convenience of the cesarean procedure (Cox, 2011). However, studies indicate that VBAC may not significantly increase risk when compared to repeated cesarean section deliveries (Hahseen, 2010; Kayani & Alfirevis, 2005). Healthcare providers must become educated in the candidate criteria for which women must qualify to be considered appropriate for VBAC as well as understand that current studies have proven VBAC can be just as safe as repeated cesarean sections. Further research is needed as current studies involve minimal randomization.