NIH Consensus Statement on VBAC

[womenswisdom]

is now posted in draft form and available for public comments today:

http://consensus.nih.gov/2010/images..._statement.pdf

[MNHall]

Thanks for posting....I can't wait to read through it!

[sweeetpea]

I have only skimmed it, but what I have read is disappointing. The conclusion seems to be "there are lots of factors that we don't really understand, so lets talk about it and study it some more". Not that I was expecting a strong statement in favor of VBAC, but this is truly mealy-mouthed.

[GoestoShow]

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Edited by GoestoShow - 1/11/11 at 10:49am

[Storm Bride]

I didn't watch it, and haven't read it, but I will do both. I did watch part of the conference about elective c-section a few years ago, and listened to the conclusion, thinking "this can't be the conference I was watching".

[_ktg_]

I know a lot of folks may have been expecting a huge smack down from NIH regarding the "bans of vbacs". I'm actually very hopeful with the panel's findings and specific pointing out - more studies are needed in these areas before recommendations are made.

In sense - its the best of what could be expected from the NIH. Let's hope many researchers, ob/gyns and midwives take up this charge and get some studies underway!!!

[AlexisT]

I think the statement is reasonable and fair. I can't ask them to do more than look at the evidence. If the studies have not been done, is that the working group's fault? They can't make recommendations based on gut instinct. The language was fairly standard compared to similar statements I've read.

I did like that they asked ACOG to change their recommendations and that it said that OBs are concerned because of increasing lack of availability (not just because they want to do VBAC but in general).

[AustinMom]

I watched the ENTIRE conference and read the statement.

The conference was good, IMO, they need to not compare medicalized TOL to ERCS. They need to compare normal, natural, physiological labor to ERCS to determine the true risks of both, as medicalized TOL usually includes induction, augmentation, pain meds, epidurals, IVs, nothing by mouth, etc. All of those can and do raise the risks of different poor outcomes. So yes, more research needs to be done, just this time, let's do the right research.

It's sad, but true, NIH can't mandate a hospital or OB to change their policies. Who can? I don't know. Not ACOG obviously, as if that were true, the CS rate would be much lower for primary and repeat CS.

In a nut shell, they are pro VBAC, and pro informed consent. But....again, you can't get an OB to practice that. There will still be OBs who don't speak of VBAC in prenatals and only state to their moms to schedule a CS.

After all, this is the third time going through this. Once in 1950s ish, and once in 1980s ish. Now, again in 2010. *SIGH* recommendations don't change policies.