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Vaginal delivery may be OK after Cesarean

July 21, 2010 12:00:00 AM PDT
Is it safe to try a natural delivery after two C-sections? National experts say it is because that would be safer than a repeat C-section. But if something goes wrong an emergency surgery can be riskier than a planned one. New guidelines give pregnant women a lot to think about.Silva Seradarian is expecting a girl. Her first pregnancy ended in a Cesarean section.

"With the twins one of them was breached and there wasn't going to be anyway that I was going to have a vaginal birth," said Seradarian.

She's scheduled for another C-section. But now, new guidelines from the American College of Obstetricians and Gynecologists say women who've already had two C-sections can choose to deliver their babies vaginally, even if they are pregnant with twins.

"It's become a very controversial issue and a very difficult issue for OB-GYNs," said OB-GYN Dr. Dafna Trites.

Dr. Trites says the new recommendations are a push to reduce the number of C-sections performed.

In 2007, 32 percent of all U.S. births were Cesarean, the highest rate ever recorded. Women who have natural births recover faster.

The American College of OB-GYNs says about 60 to 80 percent of vaginal deliveries after Cesarean, also known as a VBAC, will be successful. But what about the other 20 to 40 percent?

Studies show the risk of a uterine rupture following a VBAC runs from one to six percent. Dr. Trites says the big concern is being able to get a woman into the operating room fast enough.

"In our country it is not OK to lose even one baby or even one mom," said Dr. Trites.

After being presented with all the information, Dr. Trites say most patients opt for a repeat C-section.

"I really encourage people to ask their questions and be really well informed about what the risks are," said Dr. Trites.

"For me I think the best choice is to have another C-section," said Seradarian.

Dr. Trites says a better way to attack the rising rates of C-sections would be to focus on women who schedule first time cesarean deliveries. She says many women get them for convenience and many doctors prefer C-sections because it's a more controlled environment.


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