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Related Experiment Videos

Elective repeat cesarean sections: how many could be vaginal births?

P Norman1, S Kostovcik, A Lanning

  • 1Department of Family and Community Medicine, University of Toronto, Ont.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|August 15, 1993
PubMed
Summary

Many women eligible for a trial of labour after cesarean birth did not have one discussed. Increased education is needed to promote appropriate use of vaginal birth after cesarean (VBAC) and repeat cesarean sections.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Health

Background:

  • Repeat cesarean sections are common.
  • Guidelines exist for trial of labor after cesarean (TOLAC).
  • Vaginal birth after cesarean (VBAC) is a viable option for many women.

Purpose of the Study:

  • To assess eligibility for TOLAC among women undergoing elective repeat cesarean section.
  • To determine the rate of VBAC discussion with eligible women.
  • To identify reasons for not attempting TOLAC.

Main Methods:

  • Chart audit of 313 women with prior cesarean births.
  • Analysis based on 1986 and 1991 guidelines for TOLAC eligibility.
  • Review of documented discussions regarding VBAC.

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Main Results:

  • Only 30% of women attempted TOLAC; 71% were eligible by 1986 guidelines.
  • VBAC discussion was documented for only 11% of women undergoing elective repeat cesarean.
  • Of those with documented VBAC discussion, 79% chose TOLAC.

Conclusions:

  • A significant proportion of women eligible for TOLAC undergo elective repeat cesarean.
  • Lack of documented VBAC discussion is prevalent.
  • Enhanced physician and patient education is crucial for appropriate VBAC and repeat cesarean decision-making.