Elective repeat c-sections ‘safer’ but risks for attempting natural birth still small, say experts

Experts put repeat planned caesarean and VBAC (vaginal birth after caesarean) risks into context


Opting for a caesarean after having previously given birth by c-section could be safer, two studies have suggested.


In one study – involving 2,300 women and their babies in Australia – it was found that mums who had a planned repeat c-section had a lower risk of complications than mums who had a planned VBAC (vaginal birth after caesarean).

In the case of elective repeat c-sections, the risk of serious complications or death for the baby was 0.9%, for the planned VBAC, it was 2.4%, reports Science Daily. For the mums, the risk of a major hemorrhage was 0.8% for planned repeat c-sections and 2.3% for planned VBAC.

However, it doesn’t seem to be a cut-and-dried case of c-sections being the only choice. “Both modes of birth have benefits and harms. However, it must be remembered that in Australia, the risks for both mother and infant are very small for either mode of birth,” said Professor Caroline Crowther, from the Australian Research Centre for the Health of Women and Babies.

This is a sentiment echoed here in Britain by Dr Maria Knight, of the National Perinatal Epidemology Unit, in relation to the second study, this time from UK.

The UK study found when mums had a planned repeat c-section, the chance of womb rupture was lower than when trying for a VBAC. In the case of the VBAC, the risk of the womb rupturing was seven times higher.

It sounds huge but overall the risk is low, equaling two in 10,000 UK pregnancies, reports the BBC.

“This does give a true idea of the risk [of womb rupture] for the first time [in the UK] – in fact it’s lower than what we’ve been estimating before. The important thing to remember is the absolute risks – seven times a small risk is still a small risk,” said Dr Marian to the BBC.

Dr Virginia Beckett, from the Royal College of Obstetricians and Gynaecologists (RCOG), commented on the two studies: “Choosing a vaginal birth or a caesarean section carries different risks and benefits but overall either choice is safe with only very small risks.”


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