Vaginal birth after cesarean: whatʼs new in the new millennium?

Flamm, Bruce L.

doi:10.1097/00001703-200212000-00004

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…A summary of published evidence to date with recommendations for midwifery practice has been recently published 30 . As others have recently described, perhaps it is time to move back toward a middle ground where carefully selected and managed, low‐risk, well‐informed clients are offered the choice of VBAC with staff well prepared to handle emergencies 31,32 …”

Section: Resultsmentioning

confidence: 99%

Vaginal Birth After Cesarean Section: A Pilot Study of Outcomes in Women Receiving Midwifery Care

Avery

Carr

Burkhardt

2004

J Midwife Womens Health

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A recent trend discouraging or not offering women a choice to labor after a cesarean birth has resulted in higher cesarean birth rates and lower rates of vaginal birth after cesarean birth (VBAC). The few studies describing midwifery practice have demonstrated favorable outcomes; however, the studies are too small to thoroughly evaluate critical outcomes. In this retrospective descriptive study, clinical outcome data were obtained from eight midwifery practices. The aims were to collect, aggregate, and analyze data from multiple midwifery practices and then describe outcomes. Usable data representing 649 trials of labor were submitted. Overall, 72% (range 64%-100%) of women gave birth vaginally. Mean infant birth weight was 3,501 (SD = 534) g, and the mean Apgar scores were 7.99 (SD = 1.4; median 8) at 1 minute and 8.84 (SD = 0.8; median 9) at 5 minutes. Only 5.3% (n = 14) of infants were admitted to the neonatal intensive care unit. This small retrospective study demonstrates similar outcomes to those reported in the current literature. A larger prospective study to carefully describe midwifery care outcomes using a common data collection method is needed to provide evidence for determining the continuation of VBAC as part of midwifery care.

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Section: Resultsmentioning

confidence: 99%

Vaginal Birth After Cesarean Section: A Pilot Study of Outcomes in Women Receiving Midwifery Care

Avery

Carr

Burkhardt

2004

J Midwife Womens Health

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“…Risks and benefits of a trial of labor (TOL) after a previous cesarean section (CS) are the subject of many reports and debates [1,2]. When successful, a vaginal birth after cesarean section (VBAC) has maternal benefits, but if failed, morbidity with an emergency CS is higher than with a planned CS [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Outcome of subsequent delivery after a previous early preterm cesarean section

Kwee

Smink

Laar

et al. 2007

The Journal of Maternal-Fetal & Neonatal Medicine

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“…5,6 Safety issues and medicolegal considerations, however, appear to have contributed to ACOG subsequently adopting more restrictive recommendations regarding VBAC deliveries. 7,8 In 1999, the ACOG revised position became, "… because uterine rupture may be catastrophic, VBAC should be attempted in institutions equipped to respond to emergencies with physicians immediately available [italics added] to provide emergency care." 8 Meanwhile, VBAC rates climbed from 1% in 1974, to 27.4% in 1997 before declining to 12% in 2002.…”

Section: Introductionmentioning

confidence: 99%

Vaginal Birth After Cesarean in California: Before and After a Change in Guidelines

Zweifler¹

2006

The Annals of Family Medicine

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PURPOSEIn 1999 the American College of Obstetricians and Gynecologists (ACOG) adopted more-restrictive guidelines for vaginal birth after cesarean delivery (VBAC). This study assesses trends in VBAC in California and compares neonatal and maternal mortality rates among women attempting VBAC delivery or undergoing repeat cesarean delivery before and after this guideline revision. METHODSThe 1996 through 2002 California Birth Statistical Master Files were used to identify 386,232 California residents who previously gave birth by cesarean delivery and had a singleton birth planned in a California hospital.RESULTS Attempted VBAC deliveries decreased signifi cantly from 24% before to 13.5% after guideline revision (P <.001). Neonatal mortality rates per 1,000 live births for attempted VBAC deliveries were not different from repeat cesarean delivery rates among neonates weighing ≥1,500 g in either the study periods 1996 to 1999 or 2000 to 2002. Neonatal mortality rates for attempted VBAC deliveries were higher for repeat cesarean deliveries among neonates weighing <1,500 g in the same periods (attempted VBAC: 1996(attempted VBAC: -1999.2; 95% Poisson confi dence interval [CI], 197.7-308.6;2000 CI, 254.3-419.4; repeat cesarean delivery: 1996-1999 CI, 48.3-69.9;2000). Maternal death rates per 100,000 live births for attempted VBAC deliveries were similar for both periods (1996-1999 CI, 0.1-11.0;2000 CI, 1.0-30.6).CONCLUSIONS Neonatal and maternal mortality rates did not improve despite increasing rates of repeat cesarean delivery during the years after the ACOG 1999 VBAC guideline revision. Women with infants weighing ≥1,500 g encountered similar neonatal and maternal mortality rates with VBAC or repeat cesarean delivery.

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Vaginal birth after cesarean: whatʼs new in the new millennium?

Abstract: The recent trend has been towards a more cautious approach to vaginal birth after cesarean. Some are concerned that this trend may limit childbirth options for those women who wish to avoid repeat cesarean operations.

Cited by 9 publications

References 26 publications

Vaginal Birth After Cesarean Section: A Pilot Study of Outcomes in Women Receiving Midwifery Care

Vaginal Birth After Cesarean Section: A Pilot Study of Outcomes in Women Receiving Midwifery Care

Outcome of subsequent delivery after a previous early preterm cesarean section

Vaginal Birth After Cesarean in California: Before and After a Change in Guidelines

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