Urge more women who have previously had a caesarean section to have vaginal delivery, experts say

Doctors in the United States have emphasised the safety of vaginal delivery for women who have had one or two previous caesarean sections in an attempt to “swing the pendulum back to fewer caesareans and a more reasonable VBAC [vaginal birth after caesarean] rate.”

In new guidelines the American College of Obstetricians and Gynecologists says that no woman who wishes to have a vaginal delivery should be forced to undergo a repeat caesarean section (Obstetrics & Gynecology 2010;116:450-63, doi:10.1097/AOG.0b013e3181eeb251). If a doctor is uncomfortable with a woman’s request during her prenatal care to have a vaginal delivery she should be referred to another doctor or centre, they say.

Richard Waldman, president of the college, said that the current rate of caesarean sections was unacceptably …