ACOG finally updates VBAC guidelines : HUGE NEWS!

The American College of Obstetricians and Gynecologists (ACOG) released a new guidelines today on VBACs (vaginal births after cesareans). While I was getting prepped for my c-section, the nurse told me I’d probably never have a vaginal birth (after I asked, sobbing). The clinic where my OB works does not allow VBACs. In fact, there is only one clinic here with doctors willing to do them (note that I live in a city where the hospitals/clinics serve a population of roughly 350,000…. it’s not small).

ACOG listened. And it’s about damn time. Thanks to the meeting earlier this year held by NIH, thanks to ICAN (who attended the NIH meeting), thanks to everyone making these voices heard.

Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans.

The guidelines go on to say that “women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC [trial of labor after cesarean].”

The College says that restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will if, for example, a woman in labor presents for care and declines a repeat cesarean delivery at a center that does not support TOLAC.

HUGE. While these guidelines cannot force change in hospitals and clinics, it is a start. A wonderful start. The current perception of birth is that it’s scary, that we can’t do it on our own, and that OBs and hospitals are the cure-all. The guidelines are changing, the voice is changing. Getting the word out that VBACs are SAFER than repeat cesareans, that the risk of uterine rupture is very small (less than one percent)… these things will cause change in US and that can cause change in hospitals and OB clinics.

Fifteen years ago, nearly 3 in 10 women who’d had a prior C-section gave birth vaginally the next time. Today, fewer than 1 in 10 do. Of those who attempt VBAC, between 60 percent and 80 percent will deliver vaginally, the guidelines note.

We can do this! Thanks again to all the voices out there. <3

To read ACOG’s statement: Ob-Gyns Issue Less Restrictive VBAC Guidelines

To read ICAN’s response: ICAN Responds to ACOG’s New VBAC Practice Bulletin

9 comments to ACOG finally updates VBAC guidelines : HUGE NEWS!

  • This is great! I’m so glad to hear this hopefully things can change now! I just recently went out to lunch and to the mall with a friend who ended up having a c-section and she commented that she’s sad she’d never have a vaginal birth and I hopefully kindly explained to her that that is NOT the case!


    babydickey Reply:

    That’s awesome! (that you were able to tell her she CAN have a vaginal birth). It’s sad that so many women think that. We can and will change minds and make a difference!


  • That’s awesome!!! I posted this on my Facebook. I’m glad to have read this. I knew it was true, but now that the big dawgs are saying it, it feels even better to me. Does that make sense?


    babydickey Reply:

    That definitely makes sense. It’s part of why this is so exciting–it has always been true, but do have them announce it “officially” will hopefully change the perception of birth, cesareans and VBACs!!!


  • This is great news! Although I know there will be ignorant people like your OB who will come up with various reasons to fight the evidence. I really love the new look of your blog!


  • That is awesome news! Finally some headway on this! Also, I saw this video today and thought of you! A little inspiration for the next one. 🙂


    babydickey Reply:

    Thanks – that was a beautiful (and sad) video. I just posted it on my blog for all to see 🙂


  • I think Erica made a good point. Many times, its about the other person’s own feilnegs of guilt and regret that drive those remarks, not how you present yourself.I am also well known by my friends and acquaintances for my birth advocacy, but like you, have always made it clear that the choice lies with the woman and I support that. I imagine that your friend has listened to you and probably fully supports what you do and may be even fascinated by the idea of a natural, unmedicated birth further imagine how she must feel being bound to only ONE choice for her birth because of her medical condition. That must be very hard to deal with, even if she acts like it’s no big deal. If you have examined yourself and think you have been pushy, so be it change. But if you have examined yourself and find that you really don’t think you have been pushy, then maybe look at it from a different light and realize that those defensive remarks from your friend are probably coming from a heart of regret and grief for her own birth experiences that might have been less than ideal.


  • […] This post was mentioned on Twitter by Jonathan, Linda Miranda, Cen.Tex Doula Assoc., Anthro Doula, Baby Dickey and others. Baby Dickey said: HUGE NEWS, please read: ACOG finally updates #VBAC guidelines #birth #cesarean #ICAN […]

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