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March 2012

In their March editorial, the PLoS Medicine Editors discuss two research studies published earlier in the month on the risks associated with mode of childbirth following caesarean section. In the first article, Caroline Crowther and colleagues find that the risks of very severe outcomes—such as fetal or infant death—were lower among women who planned a repeat caesarean section than among women who planned a vaginal birth. In the second paper, Kathryn Fitzpatrick and colleagues show that the risk of uterine rupture is higher among women who have had two or more previous caesarean sections, and if the time period since the last caesarean section is less than 12 months. In a Perspective paper published alongside the research, Catherine Spong considers the risks associated with attempting a vaginal delivery after a previous caesarean section.

The Editors comment: “The bigger issue raised by these findings relates to how clinicians and women can work together to make the best possible decision when so many questions remain unanswered…Together, these findings highlight the importance of pragmatic research studies, with the overall goal of improving care for future generations of mothers and babies.”

Image Credit: Petteri Sulonen (Petteri Sulonen at

Policy Forums

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