VBAC stats: Apples and Oranges

Every single time I work with a mom planning a VBAC, they are told over and over that VBAC births have TWICE* the increased chance of rupture.


And it drives me insane. Because it is NOT APPLICABLE. It has no place in education on VBAC. (Except perhaps as a scare tactic? And if that’s how it is used, RUN to another doc!)

When a mom who birthed by cesarean is expecting again, it makes NO sense to tell her the difference in rupture rate between a vaginal birth with no history of cesarean and a vaginal birth with a history of cesarean, because that is not the decision she needs to make. A mom planning a VBAC does not have the option of birthing with an unscarred uterus, so why would you share that statistic with her at all? What earthly good does it do her? It doesn’t help her to decide between VBAC and a repeat cesarean. It’s a useless piece of information for moms in that situation.

Moms who are planning a birth after a cesarean only need statistics and information on the options they actually have available to them:

Repeat cesarean

Nothing else. Parents should be given information on the risks and benefits of BOTH of these options. Risk comparisons should be solely between the two options they can choose from! And parents should be given information on the risks and benefits for *future pregnancies* as well as this one, as they deserve the full picture when they make their choices.

(Steps off soapbox…)

*The actual statistic varies widely from OB to OB. I’ve heard as dramatic as (cue the ominous music) “FOUR TIMES AS DEADLY”. The variation in “stats” is so wide I’m pretty sure it’s made up at worst – or third or fourth hand info at best. I’ve also never found a good reference supporting any of the various numbers my clients are reporting from their care providers. So I’m a tad cynical on that, too.

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