Vaginal Births after Cesarian Deemed Reasonable

This blog is a follow-up to our March 3 blog where we announced the NIH Consensus Development conference scheduled on March 8-10 to discuss the safety issues surrounding vaginal birth after previous Cesarian section.    AHRQ has released a report from that meeting that found that vaginal birth after cesarean section is a safe and reasonable choice for a majority of women.  Each year, more than 1 million cesarean surgeries are performed, and in 2007 nearly one in three births was cesarean in the U.S.  A steady increase in repeat cesarean births over the past decade has been attributed, in part, to studies that suggested there may be significant harms associated with vaginal birth after cesarean section.  Investigators found evidence which showed that while rare, maternal mortality was significantly higher for elective repeat cesarean versus trial of labor.  Additionally, risks for uterine rupture and perinatal death remain rare, but elevated for trial of labor.  Other important outcomes such as hemorrhage/transfusion, adhesions, surgical injury, and wound complications remain uncertain due to lack of consistent definition and reporting.  Moreover, investigators also found increasing evidence that women with multiple cesarean deliveries were at significant risk of life threatening conditions.  Led by Jeanne-Marie Guise, M.D., M.P.H., researchers note that evidence-based research regarding factors, such as medical liability, economics and hospital staffing that may influence patient, provider and hospital-related decisions between both types of delivery is not sufficient.  The report, Vaginal Birth After Cesarean: New Insights, was conducted by AHRQ’s Oregon Health and Science University Evidence-based Practice Center and was prepared for the NIH Consensus Development Conference held on March 8-10. Click here to review the entire draft report.