The birth world is all a twitter right now.  One of our roles as a doula is to provide evidence-based information to our clients when they have questions or concerns.  We (at least all the ones I have come in contact with) believe a woman’s body was made to birth a baby and only under special circumstances is a cesarean surgery needed.  Most of the time, the surgery is preformed because of lack of information to the pregnant mama.  If she knows the risk and benefits of her options, she is more likely to have a vaginal birth.  There are so many benefits to mama and baby after a vaginal birth versus a cesarean surgery.

ACOG (American College of Obstetricians and Gynecologists) just released an update on their stance about VBAC’s (vaginal birth after cesarean).  They now say “Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans…“.  Now the leading source of information doctors trust is on board with what studies have proven.  This is certainly a step in the right direction back to what birth should be, an empowering, joyous, natural experience.  Here is the full press release if you would like to read it.

The one aspect that has always concerned doctors is uterine rupture at the previous incision site.  While the risk is there, it is low.  Henci Goer (a leader in the birthing world) wrote a great article posted on iVillage about the facts of a VBAC from an evidence based view point.  This is what she had to say about uterine rupture:

Symptomatic scar separation: The main fear with labor after a cesarean is that the scar will open enough to cause bleeding or for the umbilical cord or the baby to pass through the opening. Among thirty studies totaling 56,300 VBACs, the rate of symptomatic scar separation was 4 per 1,000 (15,30). Even so, few instances where this occurs result in harm to the baby, which is the real issue. The perinatal mortality rate (stillbirths and newborn deaths together) from this cause was 3 per 10,000. This did not differ from the perinatal mortality rate of 2 per 10,000 in 29,900 planned cesareans. Nor does planning a cesarean eliminate the risk of the scar giving way. Several large studies reported scar separation rates ranging from 2 to 3 per 1,000 with repeat cesarean, not much less than the 4 to 6 per 1,000 reported in VBAC labors (17,21,30).

Now, the next step is preventing the need for a VBAC in the first place.  The more we speak up and are informed, the quicker we can create change.  Birth is natural and normal, not a condition to be treated.