ACOG finally updates VBAC guidelines : HUGE NEWS!

The American College of Obstetricians and Gynecologists (ACOG) released a new guidelines today on VBACs (vaginal births after cesareans). While I was getting prepped for my c-section, the nurse told me I’d probably never have a vaginal birth (after I asked, sobbing). The clinic where my OB works does not allow VBACs. In fact, there is only one clinic here with doctors willing to do them (note that I live in a city where the hospitals/clinics serve a population of roughly 350,000.… it’s not small).

ACOG listened. And it’s about damn time. Thanks to the meeting earlier this year held by NIH, thanks to ICAN (who attended the NIH meeting), thanks to everyone making these voices heard.

Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans.

The guidelines go on to say that “women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC [trial of labor after cesarean].”

The College says that restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will if, for example, a woman in labor presents for care and declines a repeat cesarean delivery at a center that does not support TOLAC.

HUGE. While these guidelines cannot force change in hospitals and clinics, it is a start. A wonderful start. The current perception of birth is that it’s scary, that we can’t do it on our own, and that OBs and hospitals are the cure-all. The guidelines are changing, the voice is changing. Getting the word out that VBACs are SAFER than repeat cesareans, that the risk of uterine rupture is very small (less than one percent)… these things will cause change in US and that can cause change in hospitals and OB clinics.

Fifteen years ago, nearly 3 in 10 women who’d had a prior C-section gave birth vaginally the next time. Today, fewer than 1 in 10 do. Of those who attempt VBAC, between 60 percent and 80 percent will deliver vaginally, the guidelines note.

We can do this! Thanks again to all the voices out there. <3

To read ACOG’s statement: Ob-Gyns Issue Less Restrictive VBAC Guidelines

To read ICAN’s response: ICAN Responds to ACOG’s New VBAC Practice Bulletin