NIH Holds Conference on “Vaginal Birth After Cesarean” Safety and Availability

An independent panel met at the National Institutes of Health Wednesday to discuss whether vaginal birth after cesarean (VBAC) is a safe or accessible procedure for pregnant US women. The panel consisted of gynecologists, obstetricians and experts in maternal/fetal pain, according to RH Reality Check. They discussed the advantages and risks of both a vaginal delivery and a repeat cesarean, citing a wide range of statistical medical data for and against both cases. According to an NIH press release, Dr. F. Gary Cunningham, panel chair, and chair of obstetrics and gynecology at the University of Texas Southwestern Medical Center at Dallas said, “Declining VBAC rates and increasing cesarean delivery rates over the last 15 years would seem to indicate that planned repeat cesarean delivery is preferable to a trial of labor. But the currently available evidence suggests a very different picture: a trial of labor is worth considering and may be preferable for many women.” Dr. Cunningham cited two hospital administration surveys stating 30 percent of hospitals have stopped providing a trial of labor option because they could not accommodate the necessary conditions. 40 percent of US hospitals ban VBAC altogether, according to RH Reality Check. The panel emphasized the importance of ensuring the “immediate availability” of surgical and anesthesia personnel prior to a vaginal birth for a woman who has had a previous c-section, said RH Reality Check. USA Today reporter Rita Rubin presented true stories of families who have protested VBAC bans to the panel, RH Reality Check reported. Other audience members presented the argument to the NIH panel that mothers must have the right to choose their birthing method. However, as Susan Jenkins, legal counsel for The Big Push For Midwives, told RH Reality Check, “the panel refused to take a position on whether a pregnant woman has the same constitutional right to informed refusal as any other adult in the U.S. This is unconscionable and I wonder what this administration’s take is on an HHS panel questioning whether pregnant women are entitled to the full benefits of U.S. citizenship in regard to patient autonomy.”


RH Reality Check 3/10/10, 3/11/10; NIH Press Release 3/10/10

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