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VBAC score?


Forum: VBAC: Vaginal Birth After a Caesarean

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  #1  
March 23rd, 2010, 07:30 AM
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Wouldn't it be great if you would be able to know your chance of successful VBAC?

Well, a study has come out that says that, once you are in labor, they can predict your chance of success with a score.

Over 5,000 women were broken into two groups, in a records review. The first group was used to develop the scoring system, using the admission status of several factors. The second group was tested upon that scoring system and rated on the chances of VBAC.

The scoring criteria were based on:

Age of the Mother
Vaginal Birth History
Reason other than lack of progress for first cesarean
Cervical effacement at the time of admission
Cervical dilation of more than 4 cm at the time of admission
The scale is based on a highest score of 10. The 0 - 2 range had a 49% VBAC rate, while the 8 - 10 group had a 95% VBAC rate.

There was a high correlation of a vaginal birth prior to the cesarean and after the cesarean, enough to give the woman four points towards the score of 10. Although only three percent of the women had that history. In fact, 70% had no history of prior vaginal birth.

The authors of the study hope to find variables that can be corrected in dysfunctional labors in a hopes to prevent further cesarean surgeries.

This study can be read in its entirety:
"Vaginal Birth After Cesarean: An Admission Scoring System," by Bruce L. Flamm, MD, and Ann M. Geiger, PhD. Obstetrics & Gynecology, 90(6):907-910, December 1997.


So, what do you think?
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  #2  
March 23rd, 2010, 08:42 AM
lhug_nar's Avatar Platinum Supermommy
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I think that like all studies, this could be good and bad. It could be good because for people like me, I would've scored high and would've landed in that 95% pile... It could be bad too because women without prior vaginal births could land in that 49% range and that number could be used to scare them into another c/s. It really all depends on who's hands that scoring system lands in... Just like it all depends on who's hands the original scoring system lands in...
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  #3  
March 23rd, 2010, 01:05 PM
palmetto_moon's Avatar Mega Super Mommy
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That makes sense! One of the reasons my midwife said I was such a good candidate for VBAC and the reason the OB gave me ZERO flack about it was that I'd had 5 vaginal births prior to my C section. The OB always referenced those when telling me why she was so in favor of me trying for a VBAC.
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  #4  
March 23rd, 2010, 04:48 PM
wantingmore2love's Avatar Super Mommy
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i kinda make sence but not everyone is alike though..

i wouldnt want to be giving a score or what % chance i have of a vbac.. i want to go into labor get to 10cm and push..


but thats just me
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  #5  
March 24th, 2010, 08:31 AM
Momofapeanut's Avatar Platinum Supermommy
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I think anything that pegs us would be bad. That rating system may push doctors to not offer vbacs to certain women straight off the bat. I do agree that those types of decisions can't be made before going into labor - however, "time of admission" really irks me.

#1 on my list from my doula was to wait to go to the hospital as long as possible. Every woman's "as long as possible" will be different. It's different between my OBs and my Midwives as to the contrax timing. I just can't see how you can rate something like that. Instead, I see doctors compiling whether or not you've had a previous vaginal birth with reason for c/s and age and giving a "partial" rating.
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