VBAC, What is happening?

Vaginal Birth after Cesarean Section (VBAC) has proven to be a safe method of delivery in a wide variety of pregnancies.  Sadly, with changes in insurance and malpractice laws, the threshold to allow such a health delivery, and circumvent unneeded additional Cesarean Sections is being sabotaoged by this environment.

Bottom line, mommies and babies suffer.

The literature continues to glean that all our sophisticated interventions seem to do much less than we expect.

Yes, Modern Obstetrics made tremendous strides over the past 80 years. Dropping maternal mortality rates from 1,200/100,000 to around 7/100,000.  But this was due primarily to control of hemmorhage, infection, and preeclampsia or toxemia of pregnancy.  Genetic screening has been a welcomed intervention as well.

Sadly we have not done what we expected for more.  Drop in preterm labor rates, decreased hypoxia or cerebral palsy,, or other diseases that we have just not been able to decrease despite our modern interventions.

There are more but beyond the scope of this note.

Back to VBACs.  

The graph shows it all.

What is going on here?

Doctor life style, poor management and timing of labor, premature amniotomies, poor epidural managemnt, and low tolerance to minimal risk of VBAC are partially to blame.  

Doctors are overworked and underpaid, and are unwilling to take the smallest risk of the right subset of patients.

VBAC when monitored, in the right setting (ie NOT a vertical incision on THE WOMB), when all the parameters have been looked is a safe and effective means of delivery.  There is no need to go back to the days of high section rates because we are afraid of a simple VBAC.

There should be a call to arms of advocacy.  Talk to your doctor. Show them the graph. Read up on this. This is a crime against women and babies that suffer higher levels of Transient Tachypnia of the Newborn as well as other phenomenon.

It is your body, make an informed choice.