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Repeat c-sections vs. VBAC

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Just wanted to draw attention to an excellent article over at S&S:

Science & Sensibility » Is Elective Repeat Cesarean Surgery Truly Safer Than Planned VBAC?

The short version is that in recent studies a vaginal birth after cesarean only has a marginally higher absolute risk over repeat c-sections. And this risk might be attributable to modifiable obstetric practices, like using induction drugs which are known to cause uterine rupture (!). The risk seems higher among practitioners who frequently abandon VBAC attempts and resort to a c-section--leading to, I would imagine, a higher instance of hemorrhage during an intrapartum (in-labor) c-section?

And none of the recent studies have taken the long-term effects of the cumulative scarring of repeat c-sections. I know some women who have had five, six, or seven repeat elective c-sections (I call them automatic c-sections), all because of an initial section. I know this is anecdotal, but some of the women certainly had problems later on, whether with their labors or with their babies. Makes sense.

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