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New Guidelines Promoting Vaginal Birth After Cesarean (VBAC)

ICAN of Lehigh Valley Responds to New ACOG Guidelines on VBAC

22 July 2010, 3:00 pm

 

Vaginal Birth After Cesarean is a Safe and Reasonable Option for Most Women

Allentown, PA, July 22, 2010 – The American College of Obstetricians and Gynecologists (ACOG) released updated Practice Guidelines for vaginal birth after cesarean (VBAC) yesterday, July 21, 2010. ACOG states that VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins and unknown uterine scars.  ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor.

“ACOG’s updated recommendations for VBAC are much more in line with the published medical research and echo what ICAN has stated for years .” says Desirre Andrews, President of ICAN.  “The benefits of VBAC cannot be overstated and if ACOG is truly ‘serving as a strong advocate for quality health care for women’ then this is a long overdue action on their part.”

ICAN, and local chapter ICAN of Lehigh Valley, hope ACOG’s new VBAC guidelines will enable women to find the support and evidence-based care that they need and deserve.  Every woman must understand the capabilities and limitations of the  care provider and facility she chooses.  Less restrictive access to VBAC will lead to lower risks to mothers and babies from accumulating cesareans.  However, more than a revision of the VBAC Practice Bulletin is required to reverse the over a decade long trend of increasing cesarean rates and decreasing VBAC rates.  ICAN challenges ACOG to take an active role in educating both women and practitioners about healthy childbirth practices; practices that not only encourage VBAC but discourage the overuse of primary cesareans.

In 2009, ICAN contacted over 2800 hospitals in the United States to determine the VBAC policy of every institution that provides maternity services.  Of these, roughly 30% had formal policies forbidding VBAC.  Another 20% had no doctors on staff willing to accept a patient planning a VBAC. The statements condemning VBAC bans within the revised VBAC Practice Bulletin provide some hope that ACOG will now take an active role in reversing the damage done by previous Practice Bulletins.  “Although there are not official bans at local hospitals in the Lehigh Valley, there are few providers who will support VBAC.  The 2009 U.S. cesarean rate was 32.3% and many hospitals in the Lehigh Valley are well above that rate. Since ICAN of Lehigh Valley was founded in August 2009, ICAN of Lehigh Valley has been contacted by many pregnant women whose providers withdraw their support of the woman’s VBAC at 38 weeks, which leaves little time for the VBAC mom to find another care provider.  We hope the new ACOG guidelines will encourage providers in our area to truly support VBAC, which includes that the pregnant woman have a trial of labor and not just tacit support through pregnancy and then requiring a scheduled repeat cesarean if she doesn’t go into labor on the providers’ schedule,” states ICAN of Lehigh Valley Chapter Leader Carrie Ballek, “I founded the local chapter ICAN of Lehigh Valley in August 2009 to provide support to women recovering from cesarean and to promote VBAC. ICAN of Lehigh Valley holds monthly support meetings on the third Saturday of every month at 10:00 a.m. at the Southern Lehigh Valley Public Library, 3200 Preston Lane, Center Valley, PA.  Meetings are free, informational and supportive.”

Women who are seeking information about how to avoid a cesarean, have a VBAC, or recovering from a cesarean can visit ICAN of Lehigh Valley’s website at www.icanoflehighvalley.com, email [email protected] or call Carrie at 610-316-7968. 

 About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved.  Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems and lacerations.  Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. www.ican-online.org/ican-white-papers

Mission statement: The International Cesarean Awareness Network (ICAN) is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean.  There are over 130 ICAN chapters worldwide, including ICAN of Lehigh Valley, the Allentown-Bethlehem-Easton chapter, which holds educational and support meetings for people interested in cesarean prevention and recovery.

Carrie Ballek

ICAN Mideast Regional Coordinator

Chapter Leader, ICAN of Lehigh Valley

(610) 316-7968

Mari Nebbaki

Co-Leader, ICAN of Lehigh Valley