Medical panel reassesses caesarean guidelines

Eliminating the difficulty of finding doctors who can help women, who have had a cesarean section before, deliver normally was the main agenda of the panel.

The panel met at a conference held in Bethesda, Md., U.S. by the National Institutes of Health and discussed the reasons behind the constant decline in the rate of VBAC, vaginal deliveries after a cesarean section in the past.

The VBAC rate has dropped from 28.6 percent in 1996 to less than 10 percent in 2009, with the cesarean rate rising to a whopping 32 percent, claimed the experts.

Guidelines reset
Bringing hope to women who wish to deliver normally after a cesarean, the panel has urged medical groups to review the current guidelines on VBAC.

The new guidelines require surgical and anesthesia teams to be instantly available at all hospitals and maternity clinics.

The panel also advised doctors to consider VBAC as a reasonable option in low risk cases, as vaginal delivery is surely the safer method.

“We found the use of VBAC is certainly a safe alternative for the majority of women who’ve had one prior Cesarean, provided that the incision was horizontal and low on the uterus”, said Dr. F. Gary Cunningham, the conference chairman and a professor of obstetrics and gynecology at the University of Texas Southwestern Medical Center in Dallas.

“About 70 percent of women who have had Cesareans are good candidates for trying for a normal birth, and 60 percent to 80 percent of those who try succeed,” he added.

The panel would also take steps to enhance the opportunities to improve the medical care of women undergoing VBAC.

Doctors still tend to follow the old rule
The panel revealed that doctors continue following the old rule of repeated cesareans due to the fear of the uterus scar getting ruptured during vaginal labor.

Some are of the view that in such cases the pressure on uterus, as in the case of vaginal labor, could be fatal to both mother and child.

Fear of malpractice lawsuits, too, leads many gynecologists to refuse vaginal deliveries after cesarean sections.

The data presented by the panel proved that these risks are minor risks and can be eliminated with extra care and vigilance.

The findings of the panel were based on technical reports and statistics presented by experts, though public comments were also taken into consideration.