Vaginal Delivery May Be OK After C-Section

Specialties Ob/Gyn

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Our c-secton rate in the USA is out of control. I am glad to see the ACOG discussing TOLAC/VBAC for the truly viable option it is for the majority of women. And I am glad to work in a facility that "allows" TOLAC/VBAC. More need to get on board and we need to educate our patients about this very important option.

lady partsl Delivery May Be OK After C-Section - US News and World Report

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Specializes in LTC, AL, Corrections, Home health.

It is okay for the vast majority of women, the problem is that there was a few negitive examples, leading to the death of one or both people involved then the liability of it scares away hospitals and physician, who then opt for the 'safer' method.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

BUT c/s is not automatically "safer" and, honestly, the ONLY uterine rupture I saw (knock wood) was on an UNSCARRED primiparous uterus! I think so many of our problems stem from an inappropriate use and number of inductions of labor. If we did not push so hard, there would very likely be fewer "failure to progress" cases ending in c/s ! I honestly think we are the cause, not the cure, oftentimes, for the many complications that arise for laboring women.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Also, in the cases where I know of hospitals that did not "allow" TOLAC, most often, it was because there was an unwillingness to provide IN HOUSE, OB- dedicated 24/7 anesthesia coverage for the case of an emergency. I find that wrong.

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Specializes in OB.

Saw this this morning. I'm also very glad to see the pendulum swinging back!

However, I can't really "blame" some hospitals for being unable to provide 24 hr. IN HOUSE anesthesia. In some of the small critical access rural hospitals I've worked there may be only 2 anesthesia providers total. One or the other is on call at any time. It's unrealistic to think that these hospitals should not be doing deliveries when the alternative is for patients who may already be driving 50-100 miles to this hospital would then have to travel another 2+ hours to the next nearest city.

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I didn't realize this was "news." The OB department at the hospital at which I trained was doing (some) VBACs when I was there in the early '80s -- and it was a pretty conservative hospital.

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Specializes in Community, OB, Nursery.

It's not 'news' that VBACs are an option per se, but it is news that the guidelines are loosening a bit and ACOG is actually encouraging TOLAC for more people versus simply making it an option. That is very good news.

I'm grateful to work in a place that does a high number of successful VBACs. Most women, given the chance, will rock it. :)

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Specializes in LTC, AL, Corrections, Home health.

Well of coorifice it isn't necessarily the safer options, but it seems to me in the eye of an ob it is the more physician controled scenerio, so they opt for that... I am glad the pendulum is swinging the other way too.

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........ I think so many of our problems stem from an inappropriate use and number of inductions of labor. If we did not push so hard, there would very likely be fewer "failure to progress" cases ending in c/s ! I honestly think we are the cause, not the cure, oftentimes, for the many complications that arise for laboring women.

Not my field of expertise, but my sister is an OB nurse with over 25 years in L&D, much of it high risk. We were actually discussing this on the phone last night and she would agree completely with you. She thinks there's far too much premature or unnecessary intervention in the labor process, and much of the higher c/s rate is a symptom of that. Her facility does permit VBAC's .....but depending on the physician the patient has to fight for it. Hopefully the new policy will help.....

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Specializes in Pediatrics.
BUT c/s is not automatically "safer" and, honestly, the ONLY uterine rupture I saw (knock wood) was on an UNSCARRED primiparous uterus! I think so many of our problems stem from an inappropriate use and number of inductions of labor. If we did not push so hard, there would very likely be fewer "failure to progress" cases ending in c/s ! I honestly think we are the cause, not the cure, oftentimes, for the many complications that arise for laboring women.

I totally agree! The human body "knows" what it's doing as far as labor and delivery goes, and I believe in the vast majority of cases, the least amount of medical intervention, the better! Looking at statistics of other countries, with much lower rates of c/s, just confirms this belief for me...

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Specializes in LTC, assisted living, med-surg, psych.

I had a VBAC after TWO c/sections back in 1988, and I'm so glad I got to do it.....it was the easiest and best childbirth experience I ever had out of my five full-term deliveries. I never needed so much as a Tylenol during ten hours of labor; of course, in those days I had to be monitored internally but it was well worth it. I was going to do things the same way with my last child, but he was 10 1/2 lbs so I wound up with a third 'section' (for which I was very grateful, I might add :)).

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
I didn't realize this was "news." The OB department at the hospital at which I trained was doing (some) VBACs when I was there in the early '80s -- and it was a pretty conservative hospital.

I had my daughter by VBAC in 1990 when the consensus from most of the OBs was that it was safe except in very rare instances. I didn't worry about it and I was so glad to have my last child a natural birth. By the mid-90s the buzz had become much more cautionary. I'm not sure if that was related to statistics or malpractice fears. Glad to see the pendulum swinging back, though.

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