RCOG and VBAC

ISSN 0256-5004 (Print)

AIMS Journal 2007, Vol 19, No 3

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 apear 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 editor@aims.org.uk

References

  1. Royal College of Obstetricians and Gynaecologists. Caesarean section Consent Advice 7. May 2006 www.rcog.org.uk/index.asp?PageID=1633
  2. RCOG Green Top - Birth After Previous Caesarean Birth (45) February 2007 www.rcog.org.uk/index.asp?PageID=1633

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