Vaginal birth after cesarean delivery: practice patterns of obstetrician-gynecologists.
OBJECTIVE
To assess obstetrician-gynecologists' current practice patterns and opinions regarding vaginal birth after cesarean delivery (VBAC).


METHODS
Questionnaires were mailed to a random sample of 1,200 American College of Obstetricians and Gynecologists (ACOG) fellows in July 2003. Information was gathered on percentage of cesarean and VBAC deliveries performed, factors influencing changes in these rates in the past 5 years, hospital protocol regarding VBAC and factors influencing the recommendation of VBAC.


RESULTS
Fifty-three percent of questionnaires were returned to ACOG after 3 mailings. Approximately 49% of respondents reported that they were performing more cesarean deliveries than they were 5 years earlier. The primary reasons for this increase were the risk of liability and patient preference for delivery method. More than 25% of physicians reported that they practiced in hospitals that do not follow the ACOG guidelines with respect to resources and immediate availability. Almost all (98.2%) respondents agreed that they knew the risks and benefits of VBAC. However, only 61% reported feeling competent in determining which patients will have a successful VBAC.


CONCLUSIONS
Obstetrician-gynecologists seem to be aware of the risks and benefits of VBAC; however, there is some doubt as to who should be offered a trial of labor and what predicts a successful VBAC.
Coleman
Victoria H
VH
Department of Research, American College of Obstetricians and Gynecologists, Washington, DC 20024, USA. vc0014a@american.edu
Erickson
Kristine
K
Schulkin
Jay
J
Zinberg
Stanley
S
Sachs
Benjamin P
BP
D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006176:Gynecology; D006306:Health Surveys; D006801:Humans; D008297:Male; D009774:Obstetrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D014481:United States; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*