Vaginal Birth: iVillage Pregnancy & Parenting

“A Risk Is Found in Natural Birth After Caesarean” New York Times

“Study: Labor Risky After a Caesarean.” Associated Press

From the above titles and the articles that followed them, readers would think that a new study published in the prestigious New England Journal of Medicine showed that planned repeat cesarean was safer than vaginal birth after cesarean (VBAC, pronounced “vee-back”). However, the study concluded nothing of the kind. Slanted by quotations from Dr. Michael Greene, an associate editor of the New England Journal who wrote an accompanying editorial, the newspaper, TV and radio reports were actually another salvo in the disinformation campaign to eliminate VBAC. Before we get to why obstetricians want to discredit VBAC, let’s look first at what the study really said.

What did the study really say?

Reuters Medical News was perhaps the sole major news outlet to get it right. They ran their piece under: “Prostaglandin-Induced Labor Linked to High Risk of Uterine Rupture after C-Section.” The researchers ascertained this by comparing the rate at which the uterine scar gave way in some 20,000 women in Washington State who had a second child after having the first by cesarean. They found that the odds were:

  • 1 in 625 with a planned repeat cesarean,
  • 1 in 192 with starting labor on their own,
  • 1 in 130 with an induction of labor but without using prostaglandin to soften the cervix first,
  • 1 in 41 with labor inductions that included  prostaglandin.
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