Why are obgyns generally hesitant to do VBAC (vaginal birth after cesarean sections) births? Do previous c-sections impose added risks?

Question

I've heard that if a woman/mother, for whatever reason, has a caesarean section (c-section), all the subsequent births thereafter most likely will be done via a c-section. Is this true? Why or why not? (Of course I know you can still deliver vaginally, but that many OBGYNs will opt for c-section).

I've heard that c-sections are on the rise because they tend to do c-sections just based on the fact that the mother had a previous c-section (even if this particular birth or pregnancy had no risks to the baby or mother)... But this has not always been the case. So what are the medical reasons for the uptick in c-sections? (If we are to assume that hospitals are not in it for the money momentarily). Does having a c-section impose an added risk on following births? What are they?

Why are obgyn's hesitant to do VBAC births?

Answer 1

There are clear risks to both VBAC and repeat C-section. The relative importance of each factor can only be determined by the individual woman. With both VBAC and repeat c section as safe choices, each woman must make a decision that is appropriate for her and her family. VBAC is considered a women’s rights issue with the American College of Obstetrician Gynecologists. Doctors are advised to educate patients about all of their options – VBAC and repeat C-section. If a doctor individually opts to not perform VBACs, (s)he is obligated to refer to other doctors who do. ACOG recommends that VBAC only be performed at hospitals that offer 24-hour in-hospital anesthesia coverage which limits the number of hospitals at which VBACs can be offered. Unfortunately, even in hospitals that provide 24-hour in-hospital anesthesia, many doctors refuse to allow their patients to VBAC. Frequently, fear tactics regarding permanent infant damage or death are used to discourage women from choosing to VBAC. These statements are not based on facts. The physician's preference for a repeat section is often due to the ability to schedule and quickly complete a c section (40 minutes). VBAC usually involves spontaneously labor which can occur during the day, night, or weekend, and might take 24 hours or more. The convenience, efficiency, and money earned per unit time are very influential, but should never supersede a women’s right to choose her method of delivery.