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Rhonda: you were (and are!!) ahead of your time. They have indeed changed
and while no more pg's for women with a prior c/s (at least not to my
knowledge, but heh I am not perfect) the vbac rate has also shrunk. Part of
the reason for the study was that some tertiary care centers in the states were
getting a little (sarcasm) laid back about what could be done with (read
to) vbac women with some catastrophic results. Nowadays some
places may give women they would like to induce a whiff of synto (if cervix is
favourable etc) under careful monitoring otherwise it seems to be the so
called " elective " alias seriously coerced c/s. So, some good did come out of
that trial. Regarding vbac with prior vaginal birth: I am sure there are studies
but smaller , maybe even case studies and all retrospective. I strongly believe
we have to give up the idea of randomly controlled trials for everything.
Sometimes randomisation is unethical(such as randomising women undergoing a
perfectly normal experience: birth, to major abdominal surgery even if those
randomised to vaginal birth had the worlds best midwives in the world's best
home/birthing center. It is just wrong and so we have to live with other
forms of evidence don't we?? The mind boggles, at least mine does. Also I can't
imagine that women who would agree to participate in such randomisation would be
too committed to a normal birth??
marilyn
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