Women should know more about repeat C-sections

Too many women who have had a C-section aren't aware that they can still opt for a vaginal delivery the next time, according to a small study just published in the American Journal of Obstetrics and Gynecology. The authors of the study suspect that most of these women aren't being given all the information they need in order to make this choice.

The study results were based on a survey of 155 women who had already undergone a C-section and were candidates for what doctors call a "trial of labor." While it was once believed that a woman who had undergone a C-section was at a significantly higher risk for uterine rupture during vaginal delivery, the actual risk is low about 0.5 to 1 percent. Yet the researchers found that nearly three-quarters of the women opting for a repeat C-section were not aware of these statistics. Nor were most aware of the possible complications a C-section entails, which are less likely with a vaginal delivery. Such findings are certainly suggestive, considering that a third of deliveries in the U.S. today are via C-section many of them repeat procedures.

Still, lead-author Dr. Sarah N. Berstein of Magee-Women's Hospital in Pittsburgh says that it's still not possible to say whether women's inadequate understanding of the risks and benefits significantly contribute to the high C-section rates in the U.S. and in other countries. She notes that multiple factors influence the choice between a repeat C-section or vaginal delivery and doctors' own biases, not to mention malpractice fears, are certainly among these. Dr. Bernstein also stresses that both options are typically quite safe it's the individual needs of a given patient that determine which is the better choice.

ACSH's Dr. Gilbert Ross strongly agrees that doctors need to make it a priority to inform their patients of their options, letting them learn about the risks and benefits before they make a decision. "There's obviously been a failure of communication between doctors and patients," he says. "We need to remedy that."