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Labor Deemed Beneficial for Mothers

Latest Research Shows Labor Prior to Primary Cesarean is Preferred

© Brenda Lane

Nov 20, 2008
Planning for VBAC, Stephanie Berghaeuser
Increasingly today mothers are discouraged from a trial of labor and instead encouraged to plan cesareans. Research shows that labor benefits a mother who wants a VBAC.

Expectant mothers in the US today have a 30% chance of having a cesarean. Statistics in Canada for cesareans are similar, while many countries in Europe continue to be lower. Countries such as Brazil and Mexico have cesarean rates that range from 50-90% among affluent women.

While many factors play into the increasing cesarean rate worldwide, it is not uncommon for the average expectant mother with her first baby to hear that her baby is simply "too big" and that there is no value in a trial of labor. The rationale that is often used is to ask why would mother would want to go through labor only to end up with a cesarean?

We now have evidence that shows there may indeed be a good reason to allow and even encourage women to go into labor spontaneously (especially if she would be interested in having vaginal births in the future) rather than scheduling a cesarean without any medical indication.

Research Shows Benefit of Labor Prior to Primary Cesarean

One of the biggest arguments against VBAC (vaginal birth after cesarean) for mothers is that it can lead to uterine rupture. However, new research shows that going through labor (even if it ends in a cesarean) can provide a protective benefit against uterine rupture in future births.

The most recent issue of Obstetrics and Gynecology includes an interesting study from Sidney, Australia regarding the issue of VBAC and uterine rupture. Over 10,000 mothers were included in the research who were attempting a trial of labor after having a cesarean. Only about .4% mothers in the study had a uterine rupture. Not only did the mother's risk of uterine rupture increase if her labor was induced, but it also increased if she had a planned cesarean the first time around. This result directly contradicts the mistaken belief that scheduling a cesarean causes fewer complications and is safer for the mother and baby.

Researchers concluded that "labor before the primary cesarean delivery can decrease the risk of uterine rupture in a subsequent trial of labor. A history of primary cesarean delivery preceded by spontaneous labor is favorable for VBAC."

Questions to Ask Your Care Provider

If you are expecting your first baby and you are being advised to schedule a cesarean without an indicated risk, consider doing the following:

  1. Share this study with your care provider.
  2. Express your concern that you would prefer not to have a cesarean.
  3. Explain that not only is it important that you be given the chance to give birth vaginally with your first baby, but even if you have a cesarean, there is a benefit for you to labor with your next birth in mind.

Some women are reluctant to disagree with their care providers or they believe that the care provider knows what is best for them. Bear in mind that it is the responsibility of medical care providers today to practice with evidence-based medicine. If your care provider is not supportive of your desire to have a trial of labor or to have a VBAC, leave that practice and find someone who can meet your needs.

Additional Ways to Increase VBAC Success

If you have already had a cesarean and plan to have a VBAC, some of the ways to increase your chances of success include going into spontaneous labor rather than be induced, avoid getting an epidural too early, use a birth doula to help you with comfort measures and positions, choose a care provider with a low cesarean rate/high VBAC rate and be sure your entire birth team is supportive of your plan to have a VBAC.


The copyright of the article Labor Deemed Beneficial for Mothers in Pregnancy & Childbirth is owned by Brenda Lane. Permission to republish Labor Deemed Beneficial for Mothers in print or online must be granted by the author in writing.


Planning for VBAC, Stephanie Berghaeuser
        


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Comments
Dec 30, 2008 4:23 AM
Guest :
mmm was with my daughter during her labour which ended in emergency cesarean and we were all distressed` and traumatised at first because it seemed such suffering of 20 hours labour was needless .However I have been thinking that her body now has the psychological advantage of knowing she has given birth.-is it possible that to have an elective cesarean leaves the body wondering where the baby it was carrying has gone? Are there any indications that the labour itself is significant for body wellbeing ? This was her first baby and she went through loss of dignity and innocence in those 20 hours of labour with no birth resulting from this hard work so we are searching for some positive purpose of it all .And this is what seems to be an answer somehow ---ie. that her body can connect with the reality of having birthed a child without it just being cut out of her being .
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