Sunday, August 22, 2010

An Interesting Read... from 2006!

In September 2006 I was trying to convince my husband that another child would be good for our little family and a year later that is exactly what happened. However, when I got pregnant with Amelia, my OB had already decided that another c-section was my only option and refused to discuss the possibility of a VBAC. I had never thought to question her or research my options because I didn't think I had any. (This is all moot point of course because AJ was born via emergency c-section due to distress at 37 weeks- her heart rate was in the 200's!)

But, had I done any research hopefully I would have come across this wonderfully written article by Dr. Mark Landon that was posted in the Ohio State University Medical Center.
"In his most recent analysis of multicenter data collected over four years, Dr. Mark Landon evaluated the risk of complication and success of VBAC in women who had undergone more than one prior cesarean delivery. 
The 19-academic center study was led by Landon and conducted through the National Institutes of Health, Maternal Fetal Medicine Units Network. Its data included more than 45,000 patients with previous cesarean section, which included almost 18,000 women undergoing a trial of labor or an attempt at VBAC.  
Landon found that the risk of uterine rupture was 0.9 percent in cases of women with a history of multiple prior cesarean deliveries undergoing a trial of labor, compared with 0.7 percent in the cases of patients who had experienced only one previous cesarean delivery. These data challenge the notion that women with more than one prior cesarean are at dramatically increased risk for uterine rupture with a VBAC attempt."
Huh.... interesting that not only does this state the risks of VBACing with 1 c-section but multiple, AND states that the risk increases only minimally with multiple surgeries. And this was back in 2006! Before ACOG released the new guidelines stating basically the same thing- that women with multiple c-sections CAN benefit from trying for a vaginal birth.  

This study is really good because it is a huge pool of women and shows what the true risk of rupture is plus how small the risk of a catastrophic rupture (fetal death or brain damage) is. It is just too bad that it took ACOG 4 years to take notice and change its views on VBAMC.
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