Women lack info on labor versus repeat C-section

Women who have had a C-section can often opt for a natural childbirth the next time. But a small study suggests that women are making that decision without all the information they need.

In the past, doctors thought that once a woman had a C-section, she would need to do the same for any future births - mainly out of concern that the scar on the uterus would rupture during vaginal delivery.

That thinking has changed, though.

In fact, experts say a vaginal delivery has advantages for women who've had a past C-section. Moms have a shorter hospital stay and recovery time. And vaginal delivery is less likely to cause certain complications, like excessive bleeding and infection.

But the new study shows that women may not be aware of those facts when they choose between a repeat C-section or what doctors call a "trial of labor."

Researchers found that of women who'd opted for a repeat C-section, almost three-quarters did not know what the actual risk of uterine rupture would be with a trial of labor.

That risk is low - about a 0.5 percent to one percent chance, on average.

Most women were also unaware that C-section carries a relatively higher risk of breathing problems for newborns and a higher risk of death for mothers.

Fortunately, serious complications are rare, regardless of what type of delivery you choose, said Dr. Sarah N. Bernstein, who led the study.

"The point of this is not to say that one option is better than the other," said Bernstein, who was based at St. Luke's-Roosevelt Hospital Center in New York when she worked on the study.

"They are both safe options," said Bernstein, who is now at Magee-Womens Hospital in Pittsburgh.

Still, women should make their decision based on as much information as possible, Bernstein and her colleagues say.

The findings, reported in the American Journal of Obstetrics & Gynecology, are based on a survey of 155 women with a prior C-section who were all candidates for a trial of labor. The survey included multiple-choice questions on the risks associated with the two types of delivery.

Overall, 87 of the women had already opted to try vaginal delivery, while 68 had chosen a repeat C-section. Women in both groups had a tough time answering some of the survey questions.

For example, it's estimated that a trial of labor is successful between 60 percent and 80 percent of the time ("Success" means that the doctor does not have to change course in the middle of labor and do a C-section).

But only four percent of women having a repeat C-section chose the correct success rate from a list of options, and most (73 percent) did not even hazard a guess about what the correct answer was.