VBAC is safe
April 10, 2002
I am writing because I have been notified that your hospital [will] be discontinuing service to women who wish to give birth vaginally after having had a previous Caesarean (VBAC).
I am greatly disheartened at such news, as I am currently considering moving to the Aspen area and may require your VBAC services. I have recently had one successful VBAC and would need to feel confident that the major hospital in my geographic area would be willing and able to handle my care and that of my baby for any future pregnancies.
Surely you do not want to take such a giant leap backward in medical practice, given the success of VBAC births over the past few decades. Nor would you want to ignore the ample empirical data that demonstrates superior outcomes for both mothers and babies in vaginal birth.
To cite just a few reminders regarding the data on babies, infants born after elective Caesarean are more likely to have lower Apgar scores than infants born vaginally (Hurt et. al., 1988).
In addition, infants born after planned Caesareans are more than twice as likely to develop respiratory difficulties (Hook et. al., 1997). There is also more of a need for mechanical ventilation and oxygen in babies born after planned Caesarean compared with vaginal birth (Annibale et. al., 1995).
I wish I had time to cite more research, but suffice it to say that it is widely known in the medical literature that VBAC is safe, provided that the baby is closely monitored and caregivers can respond promptly to the rare problem with the uterine scar (which occurs in four per 1,000 births, according to an extensive literature review by Henci Goer for her 1999 book “The Thinking Woman’s Guide to a Better Birth”).
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I need to have confidence that a hospital staff wants and is equipped to provide (or is willing to become equipped to provide) what is best for both my baby and myself.
Andrea M. Kulberg, Ph.D.
La Jolla, Calif.