Vaginal birth after cesarean: an effective method to reduce cesarean

Clin Obstet Gynecol. 2015 Jun;58(2):309-19. doi: 10.1097/GRF.0000000000000101.

Abstract

Cesarean deliveries represent almost one third of US births. Given that repeat cesarean is the most common single indication for cesarean, trial of labor after cesarean (TOLAC) with subsequent vaginal birth after cesarean (VBAC) is an important mechanism to reduce the overall cesarean rate. The 2010 National Institutes of Health Conference found that one of the biggest barriers to VBAC is the lack of patient access to TOLAC. Many women who currently deliver by repeat cesarean would be candidates for a TOLAC. This manuscript will summarize the evidence on VBAC to help clinicians identify candidates, provide evidence-based counseling, and guide management of TOLAC.

Publication types

  • Review

MeSH terms

  • Cesarean Section, Repeat* / adverse effects
  • Cesarean Section, Repeat* / methods
  • Evidence-Based Medicine / methods
  • Female
  • Humans
  • Patient Selection
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / prevention & control
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Risk Assessment
  • Trial of Labor
  • United States
  • Uterine Rupture* / epidemiology
  • Uterine Rupture* / etiology
  • Uterine Rupture* / prevention & control
  • Vaginal Birth after Cesarean* / adverse effects
  • Vaginal Birth after Cesarean* / methods
  • Vaginal Birth after Cesarean* / statistics & numerical data