Vaginal birth after cesarean delivery in a small rural community with a solo practice

The objective of this study is to review the safety and success of a trial of labor after cesarean in a group of patients managed by a solo practitioner in a rural community. This was a retrospective review of all deliveries performed over an 11-year period by a single practitioner in a rural community. Standard contraindications for attempt at vaginal birth after cesarean were observed. Between January 1, 1989 and December 31, 1999, there were 5015 total deliveries. Women with at least one previous cesarean delivery accounted for 11.8% (593) of all patients. Trial of labor was attempted in 413 (74.5%) of these patients, and resulted in vaginal delivery in 308 (75%). Maternal complications were similar between the groups. There was no incidence of uterine rupture, maternal deaths, or neonatal deaths. Vaginal birth after cesarean can be performed safely in isolated rural hospitals with a high success rate.