History of the Process
From 1970 until 2007, a period of 37 years, the delivery rate via cesarean section in the United States increased sharply, rising from 5 percent of all births to more than 30 percent of births. The dramatic rise in C-sections came as practices in the delivery room changed – forceps deliveries and vaginal breech deliveries decreased, while the introduction of electronic fetal monitoring rose. Cesarean rates also rose because doctors became increasingly reluctant to allow natural births after the first cesarean.
However, attitudes began changing as research showed that TOLAC was a reasonable alternative, and the VBAC rates began rising from a baseline of 5 percent in 1985 to more than 28 percent by 1996, mirroring an overall trend to avoid cesareans, which comprised just 20 percent of births in that same year.
Unfortunately, while TOLAC increased, so did reports of uterine ruptures and other complications. Those reports and the professional liability that was engendered resulted in a reverse trend, with VBAC decreasing to 8.5 percent of births and C-sections rising to more than 31 percent of births. Additionally, some hospitals completely stopped offering TOLAC as an option.
The National Institutes of Health examined the VBAC issue in 2010, concluding that TOLAC was a reasonable option for women with a past history of a C-section and requested that hospitals and other medical treatment centers take another look at offering the option.
The Odds of Success
If you’re contemplating a VBAC, take some time to consider the factors that go into a successful natural birth.