Gynecology/Obstetrics and Neonatal
Vaginal Birth After Cesarean (VBAC)
March 2003
Clinical Focus*
Outcomes of a trial of labor and an elective repeat cesarean delivery
- What is the frequency of vaginal delivery in women who undergo a trial of labor (TOL) (spontaneous onset, induced, and augmented) after prior low transverse cesarean or unknown scar?
- How accurate are risk assessment tools for identifying patients who will have a vaginal delivery after a TOL?
- What are the relative harms associated with a TOL (spontaneous onset, induced, and augmented) and repeat cesarean?
- What is the incidence of uterine rupture, and are there methods for preventing major morbidity and mortality due to uterine rupture?
- What are the health status and health-related quality of life for vaginal birth after cesarean (VBAC) and repeat cesarean patients?
- Regarding VBAC and repeat cesarean, what factors influence patient satisfaction/dissatisfaction with their childbirth experience?
- How are economic outcomes related to VBAC, repeat cesarean delivery (CD), and their respective complications?
Factors influencing a trial of labor decision
- What individual factors influence route of delivery?
- What factors influence a patient's decisionmaking regarding VBAC or ERCD?
- How do legislation, policy, guidelines, provider characteristics, insurance type, and access to care affect health outcomes for VBAC candidates?
*Addressed in the summary or evidence report.
Vaginal Birth After Cesarean (VBAC)
Summary (Publication No. 03-E017, March 2003)
Evidence Report (Publication No. 03-E018, March 2003)
(PDF Files; File Download)
EPC: Oregon Health & Science University
Topic Nominator: American Academy of Family Physicians, American College of Obstetricians and Gynecologists
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