title: Vaginal birth after cesarean section: a pilot study of outcomes in women receiving midwifery care.
abstract: A recent trend discouraging or not offering women a choice to labor after a cesarean birth has resulted in higher cesarean birth rates and lower rates of vaginal birth after cesarean birth (VBAC). The few studies describing midwifery practice have demonstrated favorable outcomes; however, the studies are too small to thoroughly evaluate critical outcomes. In this retrospective descriptive study, clinical outcome data were obtained from eight midwifery practices. The aims were to collect, aggregate, and analyze data from multiple midwifery practices and then describe outcomes. Usable data representing 649 trials of labor were submitted. Overall, 72% (range 64%-100%) of women gave birth vaginally. Mean infant birth weight was 3,501 (SD = 534) g, and the mean Apgar scores were 7.99 (SD = 1.4; median 8) at 1 minute and 8.84 (SD = 0.8; median 9) at 5 minutes. Only 5.3% (n = 14) of infants were admitted to the neonatal intensive care unit. This small retrospective study demonstrates similar outcomes to those reported in the current literature. A larger prospective study to carefully describe midwifery care outcomes using a common data collection method is needed to provide evidence for determining the continuation of VBAC as part of midwifery care.
authors.affiliation: University of minnesota, School of Nursing, Minneapolis, MN 55455, USA. every003@umn.edu
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Avery
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Carr
authors.forename: Patricia
authors.initials: P
authors.lastname: Burkhardt
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008427:Maternal Health Services; D008429:Maternal Welfare; D008880:Midwifery; D009721:Nurse Midwives; D009723:Nurse-Patient Relations; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014481:United States; D016064:Vaginal Birth after Cesarean / Q000451:nursing / Q000706:statistics & numerical data*