“I have just seen so many women who have husbands who aren’t supportive because they don’t understand. My husband would love to help more men understand.”
A couple recently shared their VBA2C (vaginal birth after two cesareans) journey with me. It touched my heart. By the time I was done reading it, I had tears in my eyes.
ACOG’s 2010 VBAC recommendations affirm that VBA2C (vaginal birth after two cesareans) is reasonable in “some” women. But they remain silent on VBAMC (VBAC after multiple cesareans.) Some have interpreted that silence to mean that ACOG does not recommend VBAMC, yet ACOG is clear that women shouldn’t be forced to have cesareans.
“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?
These are the complication rates that Silver 2006 found in 30,000 women during multiple cesareans.The rates quoted were what he found during the third CS but, I think the accreta and previa rates illustrate the risks that are present during a third pregnancy after two prior CS.
If primary and secondary cesarean rates continue to rise as they have in recent years, by 2020 the cesarean delivery rate will be 56.2%, and there will be an additional 6236 placenta previas, 4504 placenta accretas, and 130 maternal deaths annually. The rise in these complications will lag behind the rise in cesareans by approximately 6 years.