WASHINGTON — Most women who’ve had a C-section, and many who’ve had two, should be allowed to try labor with their next baby, say new guidelines — a step toward reversing the “once a cesarean, always a cesarean” policies taking root in many hospitals.
Wednesday’s announcement by the American College of Obstetricians and Gynecologists eases restrictions on who might avoid a repeat C-section, rewriting an old policy that critics have said is partly to blame for many pregnant women being denied the chance.
Fifteen years ago, nearly three in 10 women who had had a prior C-section gave birth vaginally the next time. Today, fewer than one in 10 do.
Last spring, a National Institutes of Health panel strongly urged steps to reverse that trend, saying a third of hospitals and half of doctors ban women from attempting “vaginal birth after cesarean.”
The new guidelines declare VBAC a safe and appropriate option for most women — now including those carrying twins or who’ve had two C-sections — and urge that they be given an unbiased look at the pros and cons so they can decide whether to try.
Women’s choice is “what we want to come through loud and clear,” said Dr. William Grobman of Northwestern University, co-author of the guidelines.
Overall, nearly a third of U.S. births are by cesarean, an all- time high. Cesareans can be lifesaving, but they come with certain risks — and the more C-sections a woman has, the greater the risk of problems in a next pregnancy, some of them life- threatening, including placenta abnormalities or hemorrhage.
