The XX Factor

The NIH Remains Wishy-Washy on VBACs

Many women hope to give birth vaginally after experiencing a cesarean delivery-but VBAC (vaginal birth after cesarean) rates fell to an all-time low in 2004 . Fewer than 10 percent of women had a VBAC, but the medical evidence shows that about 70 percent of women can successfully give birth vaginally even after cesarean delivery -and there are ways, although none absolute, of determining which women are more at risk of complications. (The most frightening possibility is uterine rupture, which generally results in an emergency hysterectomy and can-rarely-be deadly for the baby.)

The NIH hosted a two-day long conference earlier this week, hoping to reach some consensus recommendation for VBACs. They did, but it didn’t represent much progress. Their draft statement calls for more research, more hospital policies surrounding VBAC, and policy-making to “mitigate” one of the primary things standing between women and VBACs: fear of lawsuits. The American Congress of Obstetricians and Gynecologists, along with the American Society of Anesthesiologists, were called upon to revisit their current requirements for the level of emergency response available in a hospital supporting VBACs, which some hospitals cite as a barrier. Anyone hoping for major change will be (and was bound to be) disappointed, but it does look like the medical establishment may be inching toward at least offering women an informed choice.