Kaname Uno
School of Medicine, Kyorin University, Tokyo, Japan, 2007 to 2013.
Obstetrics and Gynecology in TOYOTA Memorial Hospital, Aichi, Japan, 2013 to 2019.
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 2019 to present
Obstetrics and Gynecology in TOYOTA Memorial Hospital, Aichi, Japan, 2013 to 2019.
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 2019 to present
A mother’s intuition: successful trial of labor after Cesarean when women make an informed decision
Repeat Cesarean births can carry high risks for mothers, but so can labor for women with a history of Cesarean birth. A new study, published in BMC Pregnancy and Childbirth, which selected women at low risk of complications from labor and provided them with information on the risks and benefits of both repeat Cesarean and labor, found that more than half of the women chose trial of labor and that the vast majority of those who did so successfully avoided repeat Cesarean with very few complications. In this blog post, the author of this study summarizes the findings and recommendations for practice.
In recent years, the Cesarean section (CS) rate has been increasing with the main reason being a woman’s prior CS history. Trial of labor after Cesarean (TOLAC), with the aim of achieving vaginal birth rather than repeat CS, is considered a safe and reasonable option. However, the rate of TOLAC is decreasing, especially in Japan, and most women who are eligible for TOLAC choose elective repeat Cesarean delivery (ERCD) without receiving detailed information about the merit of TOLAC. Obstetricians who do not offer the option of TOLAC underline for these women that TOLAC is a “dangerous” option even though the risk of uterine rupture is around 0.5% and ERCD has also a variety of complications, in contrast to successful TOLAC.
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