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Panel Finds Many Women Can Avoid Repeat C-Sections

Vaginal delivery after Cesarean often safe, but roadblocks remain, experts say

By Steven Reinberg
HealthDay Reporter


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WEDNESDAY, March 10 (HealthDay News) -- Most women who have had a Cesarean delivery can safely have a vaginal delivery later, an expert panel concluded Wednesday.

Surging C-section rates in the United States have worried experts, but the panel said that just because a woman has had a C-section in the past, there's no reason she must have one in subsequent deliveries.

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However, current medical practice and fear of lawsuits are major obstacles to encouraging women to have a vaginal delivery after a C-section, the National Institutes of Health-sponsored panel said.

"This meeting was stimulated by the rising Cesarean rate all over this country, as well as the world," Dr. F. Gary Cunningham, Panel and Conference Chairman and Beatrice and Miguel Elias Distinguished Chair in Obstetrics and Gynecology at the University of Texas Southwestern Medical Center at Dallas, said during an press conference Tuesday afternoon.

Women who have one C-section are likely to have more C-sections down the line, Cunningham said.

"This has created some problems," he said." Another problem has been the voices of many women who have bemoaned the fact that they have not had access to care where a trial of labor can be offered as an delivery."

In the United States, the rate of vaginal delivery after a prior Cesarean has dropped from 30 percent to about 10 percent over the past 15 years, Cunningham noted.

To come up with their recommendations, the panel looked at all the available data as well as hearing testimony from doctors, hospital administrators and academics.

Cunningham was careful to note that the panel's findings are not guidelines to be followed, but rather a call to consider alternatives to current practice.

"What we found was the use of a vaginal delivery after Cesarean is certainly a safe alternative for the majority of women who have one prior Cesarean," he said.

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Copyright © 2010 HealthDay. All rights reserved.
Last updated 3/10/2010

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SOURCES: March 10, 2010, teleconference with: F. Gary Cunningham, M.D., panel and conference chairman, Beatrice and Miguel Elias Distinguished Chair in Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas; Carol J. Rowland Hogue, Ph.D., M.P.H., Jules & Uldeen Terry Professor of Maternal and Child Health, professor, epidemiology, and director, Women's and Children's Center, Rollins School of Public Health, Emory University, Atlanta; Nancy Frances Petit, M.D., chairwoman, Division of Obstetrics, St. Francis Hospital, Newark, Del.


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