BY DONYA CURRIE

The rate of vaginal birth after cesarean (VBAC) deliveries in the United States rose from about 5 percent in 1985 to 28 percent in 1996. But then malpractice concerns and other factors led to a plummet in VBACs, to the current rate of 8-9 percent.

Meanwhile, the U.S. C-section rate has risen steadily in recent years and now accounts for almost a third of all births--or more than double the World Health Organization target of 15 percent.

"The current cesarean rate is undeniably high and absolutely concerns us OB/GYNs," said Dr. Richard N. Waldman, president of the American College of Obstetricians and Gynecologists, in a July statement released along with the college's updated VBAC guidelines.

"Moving forward, we need to work collaboratively with our patients and our colleagues, hospitals and insurers to swing the pendulum back to fewer cesareans and a more reasonable VBAC rate."

Dr. Tom Tomzak, an obstetrician who is Fredericksburg's mayor, belives the nation's C-section rate has risen in part because of a change in the typical birth.

"In the olden days, and I'm not defending the olden days," he said, women were anesthetized and able to tolerate long, painful labors because they were unconscious.

Today's open birthing rooms allow family members to be bedside, but when they see their loved one in pain, they might demand medical intervention, he said.

Both ACOG and a 2010 National Institutes of Health VBAC panel urge doctors to pursue ways to increase VBAC rates.

"A VBAC avoids major abdominal surgery, lowers a woman's risk of hemorrhage and infection, and shortens postpartum recovery," according to the ACOG statement. "It may also help women avoid the possible future risks of having multiple cesareans such as hysterectomy, bowel and bladder injury, transfusion, infection and abnormal placenta conditions."

Dr. Scott Walker, a local obstetrician, said he has found--as with national studies--that about 80 percent of his patients who attempt VBAC do so successfully.

"The statistics show us that the majority of women would be able to have a successful, safe vaginal delivery if you take precautions," Walker said.

Stafford County mom Meg Crane said while she respected her sister's decision to have repeat C-sections, being able to give birth three times via VBAC gave her a sense of accomplishment akin to finishing a marathon.

"You just feel so great that you did it," said Crane, about VBAC.

A bonus was that after the birth of each of her children, who are now 8, 5, 3 and 1, "my recoveries were so much easier," she said.