Cesarean Section & VBAC cont...

In 1999 the largest study of uterine rupture conducted to date found the following statistics...

Uterine rupture ratio (RR) in a normal vaginal birth / intact uteri is 1: 14,866.
Maternal mortality ratio for mothers in this category is 1: 16,666

RR for successful Vaginal Birth After Cesarean is 1: 1,601
Maternal mortality ratio for mothers in this category is 1: 16,666

RR for elective primary Cesarean is 1:1,323
Maternal Mortality ratio is 1: 5,000

RR in unplanned primary Cesarean is 1: 802
Maternal Mortality ratio is 1: 3,025

RR for elective repeat Cesarean is 1:375
Maternal Mortality ratio is 1: 5,000

Total RR for post Cesarean trial of labor (TOL) is 1:187

RR for unsuccessful post CS labor ending in CS is 1:87
Maternal Mortality ratio is 1: 3,025

The "added" risk of uterine rupture a post-Cesarean pregnancy in a spontaneous labor and normal birth is four and a quarter times LESS that that of an elective repeat Cesarean and 133 times less than an induced or augmented post-cesarean labor in which Pitocin, prostaglandins, or Cytotec are used.

Gregory K, Korst L, Cane P, et al. Obstet Gynecol 94:985-9, 1999
 

Midwife-attended home birth offers the best protection against unnecessary cesarean section. The national rate for planned home births with women without history of prior cesarean section is around 3%, while the success rate for planned home VBACs is about 80%. With certain exceptions, it is legal in Montana for licensed midwives to attend home VBACS.  In the event that home VBAC is inappropriate for a particular woman, it is important that she has a skilled labor support person who can advocate for her rights and explain her options so she can make truly informed choices regarding her health care.