November 20, 2013
Majority Of Women Able To Have Natural Birth After A C-Section
Brett Smith for redOrbit.com - Your Universe Online
A new UK-based study published on Wednesday found that 62 percent of women who delivered their first child by a successful caesarian section were able to deliver their next child by vaginal birth.Published in in BJOG: An International Journal of Obstetrics and Gynecology, the study researchers said they wanted to see the attempt and success rate of a vaginal birth after caesarean.
Using data from the UK’s Hospital Episode Statistics on over 140,000 women, the researchers discovered that 52 percent attempted a vaginal birth after caesarean section (VBAC) for their second baby between 2004 and 2011.
"The majority of women with an uncomplicated first caesarean section are candidates for attempting VBAC, but our data found that only half of those women chose this option," said study author Hannah Knight, a research fellow at the Royal College of Obstetricians and Gynecologists.
The study authors found that women 24 years old or younger were more likely to attempt a VBAC than women over the age of 34, 60 percent compared to 45 percent. Black women and Asian women living in the UK were also found to have a higher rate of VBAC attempts, 62 percent and 64 percent respectively, for their second delivery when compared to white British women (49 percent).
While almost two-thirds of women who attempted a VBAC were successful, researchers found that black women had a markedly lower success rate compared to white women, 50 percent compared to 66 percent.
"Women from a non-white ethnic background were more likely than white women to attempt a VBAC, but the success rate in non-white women was lower,” Knight said. “This could point to different patient preferences or a lack of access to elective repeat caesarean section for non-white women.
The researchers also discovered that women over 34 had a lower success rate than women 24 or younger, 59 percent to 69 percent respectively. The reason for the first caesarean section was a strong factor in determining the success of a natural childbirth in the second pregnancy, the study researchers said. Additionally, women with a history of labor complications were almost twice as likely to have an unsuccessful VBAC.
"Interestingly, we also found an unexplained variation in the rate of attempted and successful VBAC between hospitals, which was independent of maternal demographic and clinical risk factors,” Knight added. "An informed discussion about whether or not to attempt a vaginal delivery after a caesarean section requires an assessment of the risk of emergency caesarean, and this paper provides valuable information both for women and the obstetricians and midwives caring for them."
"In England approximately 50,000 women per year are faced with the choice of attempting a trial of labor after having had a c-section for their first delivery,” noted John Thorp, BJOG deputy editor-in-chief. "This study shows encouraging results with the majority of women who attempted a natural delivery after a primary c-section being successful.”
"Current UK guidelines state pregnant women with a primary c-section and uncomplicated healthy second pregnancy should be given the option of a vaginal birth for their next baby, or an elective-repeat c-section, and counseled on the risks and benefits of both,” he added. “Women with any questions about their delivery options should consult with their midwife or obstetrician."