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Updated: May 17, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

Published on: January 12, 2018

VBAC in the trenches: a community perspective.

Annette E Fineberg¹, Zoe A Tilton

¹Sutter Medical Group, Davis, CA, USA. finebea@sutterhealth.org

Clinical Obstetrics and Gynecology

|October 24, 2012

Summary

This summary is machine-generated.

Vaginal birth after cesarean (VBAC) is declining significantly for low-risk women due to liability concerns, provider bias, and institutional barriers. Strategies are needed to reverse this trend and support VBAC.

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Area of Science:

Obstetrics and Gynecology
Maternal Health
Reproductive Medicine

Background:

The rate of trial of labor after cesarean (TOLAC) for low-risk women has decreased substantially since 1996.
This decline raises concerns about the accessibility of vaginal birth after cesarean (VBAC) in community settings.

Purpose of the Study:

To review the current literature on the declining VBAC rate.
To summarize expert opinions from community obstetricians and midwives regarding barriers to VBAC.
To identify strategies for increasing VBAC rates.

Main Methods:

Literature review of current research on VBAC trends.
Qualitative summary of opinions from community-based obstetricians and midwives.
Descriptive data analysis to illustrate the scope of the problem.
Case study from a community hospital experiencing a ban on VBAC.

Main Results:

Key barriers to VBAC include liability concerns, provider biases, and institutional restrictions.
A specific community hospital experienced a ban on VBAC after a previously high rate.
The decline in TOLAC affects low-risk women disproportionately.

Conclusions:

Vaginal birth after cesarean is becoming a less common practice in community settings.
Addressing liability, provider attitudes, and institutional policies is crucial to support VBAC.
Implementing strategies to encourage TOLAC is essential to reduce cesarean rates and improve maternal care options.