A US study that looked at VBAC outcomes included just over 25,000 women who had had at least one caesarean section. It showed that women with three or more prior caesarean sections experienced no difference in morbidity whether they attempted VBAC or elected for a repeat caesarean. The 89 women who had had three or more caesarean sections and who attempted VBAC were as likely to be successful as women with one or two previous caesarean sections (nearly 80%). The study suggests that precluding VBAC for women with three or more caesarean sections may not be evidence based. The Royal College of Obstetrics and Gynaecology was considering changing its advise on this – but so far still recommends caesarean section for women who have had three or more caesarean sections (see www.rcog.org.uk) (from news and views in Midwifery Matters 2010 issue 124)
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