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Vaginal Delivery May Be OK After C-Section
Date:7/22/2010

By Serena Gordon
HealthDay Reporter

WEDNESDAY, July 21 (HealthDay News) -- Many women who've had a Cesarean section may be candidates for vaginal birth in future pregnancies, say new guidelines from the American College of Obstetricians and Gynecologists.

"These guidelines emphasize again that a trial of labor after Cesarean is an important option for most women," said one of the authors of the new guidelines, Dr. Jeffrey Ecker, a maternal-fetal medicine specialist at Massachusetts General Hospital in Boston.

Years ago, experts believed that once a woman had undergone a Cesarean birth, she would have to deliver any subsequent pregnancies with a C-section as well. But with changes in surgical procedures and growing evidence to support the possibility of a vaginal birth after a Cesarean (VBAC), attitudes began to shift.

However, in the 1980s and 1990s, as the VBAC rate increased, so did complications related to the procedure. Because of concern over complications and possible legal consequences, the VBAC rate dropped dramatically, from 28.3 percent of deliveries in 1996 to 8.5 percent in 2006. But repeat C-sections also have a risk of complications for mother and baby, the authors of the guidelines noted.

Currently, almost one in three mothers delivers by Cesarean in the United States, according to the study.

More recent studies have supported the idea that many women can successfully deliver vaginally after having had a Cesarean, explained Dr. William Grobman, another author of the new guidelines and an associate professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine in Chicago. In March, a National Institutes of Health panel came to the same conclusion and said that a Cesarean delivery in the past doesn't mean a woman must automatically have one in subsequent pregnancies.

The new guidelines recommend counseling women who've had one Cesarean birth using
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