ICAN Responds to New ACOG Guidelines on VBAC

For Immediate Release
Vaginal Birth After Cesarean is a Safe and Reasonable Option for Most Women

Redondo Beach, CA, July 21, 2010 – The American College of Obstetricians and Gynecologists (ACOG) released updated Practice Guidelines for vaginal birth after cesarean (VBAC) today. ACOG states that VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins and unknown uterine scars.  ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor.

“ACOG’s updated recommendations for VBAC are much more in line with the published medical research and echo what ICAN has stated for years .” says Desirre Andrews, President of ICAN.  “The benefits of VBAC cannot be overstated and if ACOG is truly ‘serving as a strong advocate for quality health care for women’ then this is a long overdue action on their part.”

ICAN hopes ACOG’s new VBAC guidelines will enable women to find the support and evidence-based care that they need and deserve.  Every woman must understand the capabilities and limitations of the  care provider and facility she chooses.  Less restrictive access to VBAC will lead to lower risks to mothers and babies from accumulating cesareans.  However, more than a revision of the VBAC Practice Bulletin is required to reverse the over a decade long trend of increasing cesarean rates and decreasing VBAC rates.  ICAN challenges ACOG to take an active role in educating both women and practitioners about healthy childbirth practices; practices that not only encourage VBAC but discourage the overuse of primary cesareans.

In 2009, ICAN contacted over 2800 hospitals in the United States to determine the VBAC policy of every institution that provides maternity services.  Of these, roughly 30% had formal policies forbidding VBAC.  Another 20% had no doctors on staff willing to accept a patient planning a VBAC. The statements condemning VBAC bans within the revised VBAC Practice Bulletin provide some hope that ACOG will now take an active role in reversing the damage done by previous Practice Bulletins.

“It is encouraging that ACOG took seriously the recommendations made by the NIH conference on VBAC and acknowledged that language in previous VBAC Practice Bulletins recommending “immediately available” anesthesia and surgery led directly to practitioner and institutional level VBAC bans,” said Andrews. “VBAC bans place women in the untenable situation of being forced to undergo unnecessary major surgery if they are unable to find a VBAC supportive alternative.  This is a first step in returning to women an appropriate respect for patient autonomy.”  ICAN encourages all women to take the lead in decision-making about care during pregnancy and childbirth.  It is only with continued pressure from the consumer that necessary change in maternity care will happen.

Women who are seeking information about how to avoid a cesarean, have a VBAC, or recovering from a cesarean can visit www.ican-online.org.  In addition to more than 130 local chapters worldwide, the group hosts educational webinars and an active on-line discussion group that serve as resources for mothers.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved.  Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems and lacerations.  Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. www.ican-online.org/ican-white-papers

Mission statement: The International Cesarean Awareness Network (ICAN) is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean.  There are over 130 ICAN chapters worldwide which hold educational and support meetings for people interested in cesarean prevention and recovery.

17 Comments

  1. Stormy July 21, 2010 4:39 pm  Reply

    Thank you ICAN for putting out such a prompt response! I’m sharing this with the rest of the Alaska Birth Network members on our discussion board.

  2. Kimberly in MT July 21, 2010 4:48 pm  Reply

    Terrific news. Congrats on your prompt response. I’m thankful that things are starting to turn around. I will share this news widely – a woman here in town was told that VBACs were “illegal” at our hospital. A lie. Another woman I met last week from a different part of the state is scheduled for a 38 week RCS because she’s pregnant with twins. Still MUCH work to do, eh?!

  3. Lori July 21, 2010 5:13 pm  Reply

    If only this came 6 months sooner…..this is a victory yet very saddening to know that I will not be able to take advantage of these new practices…. :(

  4. Suzanne Manchester July 21, 2010 8:57 pm  Reply

    And I bet that THIS is because NYS is facing the repeal of Nurse Midwifery requirement for a doctor’s overlording supervision. Our Governer Patterson is about to sign into law the “Midwifery Modernization Act” and AGOG is attempting to lobby for his veto. Clearly they stand to lose MUCHO BUCKS when Nurse Midwives are allowed to bypass their involvement and simply help healthy women have healthy babies in a safe supported fashion. They have received a very strong message that OBGYN’s are killing their patients by opting for lucrative CSECTIONS so now they are revising their approach to save their shirts. Too bad they didn’t do it when human lives were at stake instead of when it started to hit them in the wallet. It has been 7 years since my baby and I were blocked from a midwife assisted birth in Rochester NY because of AGOG politics and I HAVE NOT FORGOTTEN!

  5. Georgia Julian July 22, 2010 12:50 am  Reply

    Sharing this on my website!!!

  6. Christy @ pureMotherhood July 22, 2010 7:50 am  Reply

    Thank you so much for publishing this article. It’s so important for women who have had a cesarean to know they have options!

  7. mm July 22, 2010 10:03 am  Reply

    It is important to note that women attempting a TOLAC should be made aware that this is a good option if they go into spontaneous labor. In our group we gladly accept people wanting to VBAC, but will not induce them with medications due to risks to the mother and baby.

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