> Another caesarean…? No thanks! Natural childbirth after cesarean, VBAC

Thereò goes against document of the World Organization of the Sanità (the WHO), which già in 1985, recommended to let a woman già cesarizzata could attempt a vaginal delivery after caesarean section (now VBAC, Vaginal Birth After Cesarean).

Even with the latest guidelines of the National Institute for Clinical Excellence in English (NICE) and the American College of Gynecology (ACOG) recommend that women già cesarizzata be sustained in trial of labor unless specific contraindications.

The have been previously been subjected to a caesarean section if it is not; an indication to perform another caesarean section.

There have been many studies of good qualityà and guidelines recent that you will find in the bibliography, which confirm as the trial of labor (PdT) is recommended for most women with a caesarean to the shoulders.

Unfortunately, there are no randomised trials and conclusive as to the benefits and risks of caesarean section, repeated vs. VBAC, and this does not put us in the condition to support absolute a modeà of the birth, than another.

Despite the title deliberately provocative to these pages, the purpose is to provide information so that you can choose thereò that you believe più suitable to you.

we would like to emphasise the right of every woman to be fully informed, as possible the current knowledge on the benefits and risks of both procedures and make a personalized choice and fully aware of it.

The majority of women with a previous caesarean section può, and should be able to give birth spontaneously, in fact, an average of the statistics indicates that among women who make a labor after cesarean about 75% able to achieve a VBAC.

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In a historic moment in which the increase in the indiscriminate cutting cesareo begins to worry seriously the agencies of the sanità the public, the cuts caesar repeated, in Italy, account for around 25% of all the caesarean sections!

To drastically lower the rate of caesarean section, of which Italy, with its 37% of the total holds now the world record, would in the meantime allow women who want to do a VBAC. the

Perché tanta paura?

The concern that leads many doctors to advise women to repeat a caesarean section is given by the possibilityà that the scar on the uterus from the previous caesarean section it may break during labor.

it is a rare event, that is good to know as it would be right to know the possible complications of repeat caesarean section but most of the information that a woman già cesarizzata you see offer at the moment in Italy, especially in the centre-south) are exclusively related to the possible damage resulting from a rupture of the uterus.

I met a lot of women who have told me what had been said to them about the VBAC to the doctor, but also from passers-by and relatives. The information received could be summed up as follows:


  • too risky
  • there is the risk that it may break the uterus
  • you can notò
  • the

  • it is impossible
  • the

  • if something goes wrong will be your fault
  • the

  • with the section you’re più quiet

this type of information generic terror is offered to the women già from the first of a new pregnancy, without ever mentioning the evidence and the statistics with the pros and cons of the caesarean section repeated vs the VBAC.

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Ivana Arena

Ivana Arena has just published the book: “After a caesarean section – How to respond to the needs of the mother and the child“. Bonomi – 13,52 euro. You can purchase it online directly from the Publisher.

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This is the map of hospitals that are favorable to VBAC. Please let us know any updates or inaccuracies.

Page last updated June 2014