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Updated: May 19, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Trial of labor versus repeat cesarean: are patients making an informed decision?
Sarah N Bernstein1, Shira Matalon-Grazi, Barak M Rosenn
1Division of Obstetrics and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St Luke's Roosevelt Hospital Center, New York, NY, USA.
Objective:
Most women eligible for a trial of labor after a cesarean (TOLAC) undergo an elective repeat cesarean section (ERCS). We hypothesized that this is largely because of poor patient education.
Study Design:
This was a prospective study of women who presented to our hospital from November 2010 through July 2011 who were candidates for TOLAC. Women filled out a questionnaire prior to their scheduled ERCS or upon admission for TOLAC. A χ(2) and a Student t test were used, as appropriate.
Results:
The study included 155 women, 87 for TOLAC and 68 for ERCS. Women in both groups demonstrated a lack of knowledge on the risks and benefits of TOLAC and ERCS. When patients perceived their providers as having a preference for ERCS, very few chose TOLAC, whereas the majority chose TOLAC if this was their provider's preference.
Conclusion:
Candidates for TOLAC appear to know little about the risks and benefits associated with their mode of delivery, and provider preference affects this choice.
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