Monday, April 7, 2014

MANA Study Part 4: Vaginal Birth After Cesarean



You are reading Part 4 of my MANA study series. Click to view:

MANA Study Part 1: Intrapartum Mortality Rates

MANA Study Part 2: Neonatal Mortality Rates

MANA Study Part 3: Total Mortality Rates

MANA Study Part 4: Vaginal Birth after Cesarean (currently reading)

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For today's post I am discussing VBAC, HBAC and the MANA study outcomes for HBACs. Let's first lay out the different acronyms:

VBAC -- Vaginal Birth After Cesarean
HBAC -- Home Birth After Cesarean
TOLAC -- Trial Of Labor After Cesarean
ERCD -- Elective Repeat Cesarean Delivery
RCS -- Repeat Cesarean Section

TOLAC refers to all women who have had a previous cesarean section (or more than one) who attempt a vaginal birth. The outcome for TOLAC may be vaginal birth (VBAC) or it may be repeat cesarean section. TOLAC therefore includes outcomes for both.

ERCD refers to all women who decided to forgo an attempt at vaginal birth. ERCD is a bit of a deceiving term. While a cesarean section in this group is labeled as “elective” it also includes women who medically needed cesarean sections for reasons aside from having a previous cesarean section (which would mean it is not actually an elective cesarean section). Because women with chronic illnesses, or other such medical contraindications for TOLAC, are lumped into the ERCD group, the risks of ERCD may be overestimated.


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I'm briefly going to discuss various aspects surrounding VBAC before discussing the startling increased risk for babies born at home to mothers attempting a HBAC.

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