New guidelines: VBACs are likely to be safe and successful

Published on: 04/10/2015

 

The RCOG (Royal College of Obstetricians and Gynaecologists) have updated their current guidelines on VBACs (vaginal births after caesareans).  The guidelines state that a VBAC is considered, based on current evidence, to be a clinically safe choice for most women who have had one previous section.  Research indicates that VBAC has a success rate of around 75% – which is the same as for first time mothers and this rate rises to 85-90% if the woman has had a previous successful vaginal birth.  Even after two or more caesarean births, the rate of success still remains high, at 71%.

 

These guidelines also provides evidence based information for doctors on how to assess a woman’s suitability for vaginal birth or repeat caesarean.  The need for personalised care is emphasised and doctors are recommended to take into consideration such factors as presentation of the baby, previous uterine rupture, type of previous incision, previous surgery and position of the placenta in their recommendations to the mothers.

 

Janesh Gupta, a professor of Obstetrics and Gynaecology and lead author of the guideline, said: “Women can be assured that in most cases it is possible and safe to have a vaginal birth after a previous caesarean section. This guideline can be used to aid doctors in their assessment of individual women and, unless there are clinical reasons why a vaginal birth should not be attempted, help inform the woman and her partner of her choices and the risks involved with either vaginal birth or a repeat caesarean section.”

 

Louise Silverton, RCM director for midwifery, said: “Women should speak to midwives and doctors about what options they have, so they fully understand what care pathway is available to them and what will be involved.”

 

View the new guidelines here

The RCOG summary can be viewed here

The RCM’s response may be found here