Want to have an old-fashioned vaginal delivery? Tough luck if you’ve had a Cesarean section in a previous delivery. Hospitals, doctors and insurers have been loathe – or flat-out refuse – to allow vaginal births after C-section (known as VBAC).

But new medical guidelines from the American College of Obstetricians and Gynecologists (ACOG) may change that. According to that organization, hospitals should respect women’s preferences about the kind of birth they want and not strong-arm them into repeat C-sections.

That’s good news for moms-to-be who don’t want to go under the knife again, especially since risks associated with VBACs are much lower than previously thought.

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You’re at your first ultrasound appointment, excited to see your first image of your baby.  But wait, there’s more than one heartbeat. Turns out you’re expecting twins… or more!

How common are multiples? Carrying two or more babies make up only about 3% of all pregnancies. But if you had multiples in a previous pregnancy, you’re more likely to have them in the future.

A Wiser Pregnancy survey found that 16% of pregnant women who were carrying twins or more had a multiples pregnancy in the past. But that’s not the only cause: Heredity, older age, personal history, race and fertility drugs and treatments also boost the odds.

But multiples bring a downside: a greater risk of complications during pregnancy, including: 
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Very few people choose surgery, especially if there’s a non-invasive, cheaper treatment around. Yet when it comes to pregnancy, plenty of women opt to go under the knife.

More women in the U.S. have been having Cesarean sections than ever before, despite the risks involved. In fact, 32% of babies born in 2007 were delivered via C-section – an all-time high.

 A Wiser Pregnancy survey bears this out. Of more than 1,500 women surveyed, 26% of them have had one previous C-section; 12% have had more than one surgical delivery. 

Of women who have had a C-section in the past, only 16% successfully delivered vaginally (VBAC) in a subsequent pregnancy.

Why are so many women having C-sections?
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Sometimes it feels like the baby is never going to come out. If so, you may be thinking about inducing labor, just to hurry it along. It’s a popular choice: In 2007, for the 11^th consecutive year, the number of C-sections in the U.S. rose, reaching 31.8% for all live births, according to the CDC/National Center For Health Statistics.

However, you may want to reconsider, suggests a new study from the University of Rochester School of Medicine.  

The study found that inducing labor increases the risk that a woman will have a Cesarean delivery, one that she may not have needed if she’d waited to go into labor naturally.  The study found that 1 to 2 out of every 25 induced labors resulted in a C-section. 

Why is this a concern? Because C-sections, as common as they are, are still surgical procedures. As such, they are associated with several risks, including infection, maternal bleeding, blood clots and injury to mother or baby. Of course, C-sections are medically necessary in some circumstances: You have diabetes, high blood pressure and placenta problems; your baby is not growing well; or you’re 10 days past your due date.

However, if those don’t apply to you, the risks linked to being induced and having an unplanned C-section could outweigh the benefits.    

Fortunately, maternal health problems that may require earlier delivery are not common, according to a recent WiserPregnancy survey:

• 6% of women were diagnosed with gestational diabetes
• 5.6% of women were diagnosed with gestational hypertension (high blood pressure)
• 3.8% of women were diagnosed with placenta previa
• 1.1% of women were diagnosed with placental abruption

In many of these cases, doctors decided early delivery was necessary. 

If your condition doesn’t warrant early delivery, why is it better to wait for spontaneous (i.e., natural) labor?  Besides giving your baby more time to develop, women who are not induced avoid the risk that they will need an otherwise unnecessary C-section. 

Have you considered setting a date to be induced?  Why or why not?