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National Childbirth Survey

6. Once a c-section, not always a c-section

Following the national trend, most of the women delivered vaginally (76 percent), while about one-quarter had c-sections. Over half of these operations were scheduled. No doubt this was due in part to the fact that 77 percent of c-section moms were going in for a repeat surgical delivery. While more than half of those women (56 percent) had the option for a vaginal birth after cesarean (VBAC), approximately one-third said that their caregiver was unwilling to consider it, and 15 percent reported that the hospital didn't allow it. Yet most women (70 percent) who had a cesarean said that next time around, they were "not likely at all" to want to have another operation.

The fact is that a VBAC is not a viable option for all women, but that it should be available to women who are ideal candidates. Factors that increase the danger of uterine rupture during a VBAC include having a second baby within 18 months of the first, having a vertical incision on the uterus, and inducing labor via prostaglandin gel. Pregnant women who have previously delivered by cesarean should discuss the option with their caregivers to find out whether they carry these risks or if a VBAC might be a viable option. In addition, women need to know at the outset if their caregivers and their hospitals are willing to allow VBACs.

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