In recommendations that could make a dent in the nation's rising C-section rate, a national group of experts on Wednesday called for a revision of hospital guidelines to allow more women to avoid a repeat Cesarean birth.

Vaginal birth after a C-section "certainly is a safe alternative for a majority of women," said F. Gary Cunningham, chair of the consensus committee for the National Institutes of Health. Hospitals and doctors also should make public their rates and policies about vaginal birth after a C-section, the committee said.

Citing a lack of research, the committee said it could not go further to pinpoint which women can safely undergo a vaginal birth after Cesarean or how factors such as age and weight affect a woman's ability to undergo natural childbirth. "We can't go stronger; these are the strongest recommendations we can make," Dr. Cunningham said.

The recommendations are to be posted soon on an NIH Web site for consensus reports, www.consensus.nih.gov.

Debra Bingham, president-elect of Lamaze International, a proponent of natural childbirth, said her group and others will circulate the findings so that couples can discuss birth choices with their doctors. "The pendulum has swung too far," she said, citing C-section rates at 31 percent, an all-time high in the U.S.

The recommendations will put pressure on two large doctor groups to change their guidelines, saying hospitals should not allow women with a prior C-section to undergo natural childbirth if the hospital does not have obstetricians and anesthesiologists around the clock.

Those recommendations from the American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists are under review, an ACOG spokesman said.

Sonia Hassan, a Wayne State University School of Medicine obstetrics and gynecology associate professor, said the new recommendations should trigger "a push for doctors to educate women in a more individualized way."

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