VBAC Safety: A Closer Look at the 2002 JAMA Study

Once again, newspaper articles claim that a study has shown that elective repeat cesarean is safer for babies than vaginal birth after cesarean (VBAC) (14). As with the July 2001 study, closer analysis reveals no such thing (6). What the new study really shows are the dangers of the first cesarean.

Here's the gist of the study: Scottish researchers collected data on over 313,000 births, excluding pre-term births, breech babies and babies with malformations. They compared infant death rates during labor and up to a week after birth among women having trial of labor, planned repeat cesarean, first-time mothers and women with only vaginal births. They got the following results:

-- 13 babies per 10,000 (20 out of 15,500) died in the trial-of-labor group
-- 1 baby per 10,000 (1 out of 9000) died in the planned repeat cesarean group
-- 10 babies per 10,000 (135 out of 137,000) died in the first-time mothers group
-- 6 babies per 10,000 (90 out of 151,500) died in the only vaginal births group
-- 3/4 of the trial-of-labor group birthed vaginally

The study recommended that all women with prior cesareans have a scheduled cesarean at 39 weeks of pregnancy.

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