A mom recently asked, “I know I’m asking for a lot, but is there a list of rupture rates by weeks gestation ?”
This is a great question as many women are under pressure from their care provider to go into labor as early as 37 weeks, but more commonly 40 weeks, or they will have a repeat cesarean.
Let’s first look at what ACOG says in their 2010 VBAC recommendations,
Studies evaluating the association of gestational age with VBAC outcomes have consistently demonstrated decreased VBAC rates in women who undertake TOLAC [trial of labor after cesarean] beyond 40 weeks […]
There is this idea that if you don’t VBAC and you schedule a repeat cesarean, that you will be safe from complications. This is because during a “VBAC counsel,” women are often told of the risks of VBAC, namely uterine rupture, but they are rarely told the risks of repeat cesareans in their current and future pregnancies.
Abnormal placental implantation is one risk of cesareans that only present themselves when you get pregnant again.
Women who expect to only have two children, and thus opt for a repeat cesarean, might think that not VBACing is the safer, and more controlled […]
Here is another response to the statement dated December 2007 from Hastings Indian Medical Center explaining why they no longer offer VBAC.
Wow is this article amazing for being published in the post-2004 “anti-VBAC per ACOG” era, by two MDs no less! If your OB gives you the third degree about VBAC, you might want to give him a copy of this article. The tide against VBAC might be turning!
Dated February 2008, not only does it openly and explicitly encourage VBAC, but it also:
declares VBAC as the “safest option” encourages efforts to “minimize the primary cesarean delivery rate” […]