Vaginal birth risky after first caesarean

A study involving more than 2000 women in 14 maternity hospitals found elective repeat caesarean reduced the risk of stillbirth, serious infant outcomes and major maternal haemorrhage compared to planned vaginal birth after caesarean.

One infant death would be prevented for every 66 elective repeat caesareans, according to results from the study led by Professor Caroline Crowther from the Robinson Institute at the University of Adelaide.

“Until now there has been a lack of high-quality evidence comparing the benefits and harms of the two planned modes of birth after previous caesarean,” Professor Crowther said.

The first of its kind study recruited 2345 women with previous caesarean. Few (22) accepted randomisation and the others were assigned according to patient preference (1225 to vaginal birth and 1098 to caesarean).

Among those in the planned vaginal birth group, more than half (702) ended up having a caesarean including