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On the acronym TOLAC (trial of labor after cesarean)…. Some studies break out statistics in four ways. 1. ERCS/D (elective repeat cesarean section/ delivery) 2. VBAC (vaginal birth after cesarean) 3. CBAC (cesarean birth after cesarean aka cesarean after planned VBAC) 4. TOLAC TOLAC often includes VBAC and CBAC stats because as a post-cesarean mom, [...] 
While these statements are very comforting, as birth myths tend to be, they are false comparisons. We can accurately and fairly compare the risks of a TOLAC to the risks of a repeat cesarean or the risks of a first time time. However, it is a misleading to compare the risks of birth to non-birth events. [...] I have often heard moms say “if two numbers are less than 1%, they are similar.” Typically this is expressed while comparing the risks of rupture in an unscarred versus scarred uterus. But is this true? How different can two numbers less than 1% be? [...] “There is a major misperception that TOLAC [trial of labor after cesarean] is extremely risky” – Mona Lydon-Rochelle MD, March 2010. “In terms of VBAC, “your risk is really, really quite low” – George Macones MD, March 2010. Both Drs. Macones and Lyndon-Rochelle are obstetricians and researchers who made these statements at the 2010 NIH [National Institutes of Health] VBAC Conference. Now you may think, “Wait a sec. Everything I’ve heard from my family, friends, and medical provider is how risky VBAC is and how cesareans are the conservative, prudent, and safest choice.” Why the discrepancy between the statements of these two doctor researchers and the conventional wisdom prevalent in America? [...] 
How many times have you heard “Only 6% of uterine ruptures are catastrophic” or “Uterine rupture not only happens less that one percent of the time, but the vast majority of ruptures are non-catastrophic?” But what does that mean? Does that mean only 6% of uterine ruptures are “complete” ruptures? Result in maternal death? Infant death? Serious injury to mom or baby? This article will explain to you the difference between uterine rupture and uterine dehiscence as well as explain the source and meaning of the 6% statistic. [...] VBAC Facts reviews a blog post that shares a study on VBAC along with statistics the blogger calculates, many of which misrepresents the risk of uterine rupture and infant mortality during a VBAC attempt demonstrating why it is important to not only know the source of the statistics, but also know that the blogger can do simple math. [...] 1/18/12 – The difference in uterine rupture (UR) rates between unscarred and scarred uteri is significant: 1 in 14,286 in an unscarred uterus and 1 in 156 in a scarred uterus. Another way to express this is: 0.7 in 10,000 (0.007%) in an unscarred uterus and 64 in 10,000 (0.64%) in a scarred uterus. This [...] Update 1/20/12 – Someone who believed this birth myth to be true, told me that the source of this information was an OB from St. Louis who presented at the 2011 ICAN conference. I contacted ICAN and they said that the person must be referring to Dr. George Macones. Yet, no one on the ICAN [...] When someone understates the risk of UR, I think it’s just as important the clarify as it is when someone overstates the risk. How else are women to make an informed decision? Just as it’s plain wrong for an OB to tell a woman with one prior low transverse cesarean that she has a 20% [...] A couple weeks ago Virginia from Switzerland left this comment: I am planning to have a vbac at a hospital in Geneva, Switzerland. In general, they are very supportive of vbacs here. It is common practice here to measure the uterine scar at 37 weeks using a sonogram. Apparently, if the scar tissue is 3.5mm [...] |
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