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Care For Individuals Desiring Vaginal Birth After Cesarean Birth
Whitney Miller1, Anjali Madeira1,2, Gianna Fay1
1American College of Nurse-Midwives, Richmond Hill, Georgia.
Journal of Midwifery & Women'S Health
|July 9, 2026
Summary
Women with a prior cesarean birth face choices between labor after cesarean (LAC) and elective repeat cesarean birth (ERCB). This bulletin provides evidence-based guidelines for midwives on LAC care, including risk assessment and shared decision-making.
Area of Science:
- Obstetrics and Gynecology
- Midwifery
- Maternal-Fetal Medicine
Background:
- Women with a previous cesarean delivery often receive conflicting information regarding subsequent birth options.
- Labor after cesarean (LAC) and elective repeat cesarean birth (ERCB) present distinct benefits and risks for both parent and neonate.
Purpose of the Study:
- To provide evidence-based guidelines for midwives and healthcare providers caring for individuals considering LAC.
- To support informed choices, shared decision-making, and appropriate clinical care for LAC.
- To address considerations regarding the optimal site of birth for LAC.
Main Methods:
- Clinical bulletin development based on current evidence.
- Review of risk assessment strategies for LAC.
- Guideline formulation for patient education and shared decision-making.
Main Results:
- Guidelines address comprehensive care for individuals pursuing LAC.
- Emphasis on risk assessment, informed consent, and shared decision-making processes.
- Considerations for birth location are integrated into the recommendations.
Conclusions:
- Midwives and healthcare providers can utilize these guidelines to optimize care for individuals considering LAC.
- Promoting informed choices and shared decision-making enhances maternal and neonatal outcomes.
- Evidence-based practice is crucial for navigating the complexities of LAC versus ERCB.
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