Vaginal birth after a caesarean is not always beneficial

doi:10.1136/bmj.39262.430706.3A

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Paul T-Y Ayuk, obstetrician and gynaecologist

John Radcliffe Hospital, Oxford OX3 9DU

paul{at}busyspr.com

The study by Montgomery et al and the accompanying editorial are based on the premise that vaginal delivery after one caesarean section is necessarily a beneficial and desirable objective or outcome.1 2 However, the risks and benefits as published in the recent RCOG (Royal College of Obstetricians and Gynaecologists) guidelines3 can be summarised as follows:

Risks …