We have been aware for many years that the risk of uterine rupture in a future pregnancy is underplayed by obstetricians when a caesarean is being suggested to a woman, and then suddenly it is put over as a grave concern when they want a VBAC, however we were still surprised to find the RCOG put this inconsistency of information into black and white.
In their advice on obtaining consent of women for a caesarean1 they state:
Serious risks include: ... Increased risk of uterine rupture during subsequent pregnancies/deliveries - up to 0.4' [%]
Yet in their guideline on VBAC2 they say:
Women considering the options for birth after a previous caesarean should be informed that planned VBAC carries a risk of uterine rupture of 22-74/10,000' [0.22 - 0.74%,nearly a doubling of the risk]
It would appear that the mean risk of rupture is quoted at consent. Neither guide gives women the information that for a normal birth the risk is in the region of 0.22%, but if her labour is induced the risk rises almost four fold to 0.74%. Are these figures quoted in a way which leads women to misunderstand the risks? Please send your comments to email@example.com
AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all.
The AIMS Journal spearheads discussions about change and development in the maternity services. From the beginning of 2018, the journal has been published online and is freely available to anyone with an interest in pregnancy and birth issues. Membership of AIMS continues to support and fund our ability to create the online journal, as well as supporting our other work, including campaigning and our Helpline. To contact the editors, please email: firstname.lastname@example.org
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