Research suggests women who have had a caesarean section in a previous pregnancy are more likely to have a vaginal birth next time if their antenatal care is led by a midwife.
The study by the University of Manchester, published in the journal Birth, evaluated the influence of vaginal birth after a caesarean (VBAC) rates on midwife-led maternity care.
Researchers used 405 patient records of women giving birth at one hospital who have had a previous caesarean sections.
The first group of women gave birth in 2008, when obstetricians led antenatal care (hospital policy changed in 2009-2010), and the second group of women received midwife-led antenatal care in 2011.
The rate women who planned to give birth by VBAC in 2011 was 90.3%, in comparison to 77% of women in 2008.
Out of the women who achieved VBAC, the midwife-led group was highest with 61.2% in comparison to 46.9%.
Midwifery Lecturer and research lead at the University of Manchester’s School of Nursing, Midwifery and Social Work, Dr Helen White said: “There were a few differences between the two groups of women we studied, so the main variance was the professional responsible for their care.
“Where it can be achieved today, vaginal birth is preferable, but there’s a real issue with women who have had a caesarean once, opting for the same again. There aren’t many initiatives out there to break this cycle so this finding is important for providing evidence that midwives are best placed to promote vaginal birth.”
Additional research has been published suggesting that while caesarean sections are considered safe, vaginal birth can protect against long-term risks such as asthma, type 2 diabetes and impairment of the immune system.
“The more we understand the role of the microbes living in the vagina, the more we are uncovering the protective effects of labour and natural birth against conditions such as diabetes and obesity,” Dr White added.
The full research paper can be found on the Wiley Online Library.
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