Vaginal Birth After Cesarean is a Safe and Reasonable Option for Most Women
Redondo Beach, CA, July 21, 2010 – The American College of Obstetricians and Gynecologists (ACOG) released updated Practice Guidelines for vaginal birth after cesarean (VBAC) today. ACOG states that VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins and unknown uterine scars. ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor.
ICAN hopes ACOG’s new VBAC guidelines will enable women to find the support and evidence-based care that they need and deserve. Every woman must understand the capabilities and limitations of the care provider and facility she chooses. Less restrictive access to VBAC will lead to lower risks to mothers and babies from accumulating cesareans. However, more than a revision of the VBAC Practice Bulletin is required to reverse the over a decade long trend of increasing cesarean rates and decreasing VBAC rates. ICAN challenges ACOG to take an active role in educating both women and practitioners about healthy childbirth practices; practices that not only encourage VBAC but discourage the overuse of primary cesareans.
In 2009, ICAN contacted over 2800 hospitals in the United States to determine the VBAC policy of every institution that provides maternity services. Of these, roughly 30% had formal policies forbidding VBAC. Another 20% had no doctors on staff willing to accept a patient planning a VBAC. The statements condemning VBAC bans within the revised VBAC Practice Bulletin provide some hope that ACOG will now take an active role in reversing the damage done by previous Practice Bulletins.