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To VBAC or Not to VBAC

  • Catherine Y. Spong mail

    spongc@mail.nih.gov

    Affiliation: National Institute of Child Health and Human Development, Bethesda, Maryland, United States

    X
  • Published: March 13, 2012
  • DOI: 10.1371/journal.pmed.1001191

Reader Comments (1)

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Affect on Practice in the UK

Posted by SouthwarkBelle on 14 Mar 2012 at 19:27 GMT

A very interesting article and always good to have risk levels made clearer, but the section on how the studies will affect practice seems very much based on the US system, rather than the UK where one of the studies was conducted.

Here, in most hospitals, a VBAC is the default option for a delivery following a previous C-section. Elective C-sections are possible but women often have to argue their case to have one, rather than being allowed to make an informed choice. As an example, having had an emergency C-section with my first child I was informed by the hospital that I would have to gain approval from their psychiatrist, on mental health grounds should I want an elective c-section in future and that they expect women to attempt a VBAC.

The culture in our two countries seems to be very different in this respect, hopefully there will be more studies like this and women will eventually be able to make genuinely free and informed choices.

No competing interests declared.

RE: Affect on Practice in the UK

medrschr replied to SouthwarkBelle on 29 Apr 2013 at 09:02 GMT

Research from the UK (for example, Goodall et al. 2009) indicates that women are often given the choice between VBAC and repeat C-section in the UK. In fact, the 2001 Sentinel Audit (UK) regarding Cesarean section, the repeat C-section (so those either not opting for VBAC, or selected for repeat C-section by their health care provider) made up the single largest group of C-sections in the UK at that time.

The experience at the hospital mentioned is very interesting to hear about -- perhaps reflecting quite variable approaches to VBAC & decision-making in various UK locations.

No competing interests declared.