It’s safe to have a VBAC if you want one, says revised guidelines

New research confirms it's not always necessary to have another C-section

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If you’ve already had a caesarean section, it’s possible and safe in most cases to try for a vaginal birth. So say revised guidelines from the Royal College of Obstetricians and Gynaecologists (RCOG). New research confirms that vaginal birth after C-section has a success rate of around 75% – the same as for first time mothers.

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The success rate rises to 85-90% for second-time mums who have already had a successful vaginal birth. But even after two or more C-sections, the rate of success is still high at 71%.

Around a quarter of births in the UK are delivered by C-section, with 15% due to emergency intervention and 10% by choice.

The new guideline aims to help doctors advise women of all their options when considering their birth plan and urges them to use a personalised approach. Factors such as presentation of the baby, previous uterine rupture, type of previous incision, previous surgery and position of the placenta, may still mean a vaginal birth after caesarean is not recommended.

“Women can be assured that in most cases it is possible and safe to have a vaginal birth after a previous caesarean section,” Janesh Gupta, a professor of Obstetrics and Gynaecology and lead author of the guideline said. “This guideline can be used to aid doctors in their assessment of individual women and, unless there are clinical reasons why a vaginal birth should not be attempted, help inform the woman and her partner of her choices and the risks involved with either vaginal birth or a repeat caesarean section.”

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