title: An ethical framework for the informed consent process for trial of labor after cesarean delivery.
abstract: In 2010, a National Institutes of Health Consensus Panel and the American College of Obstetricians and Gynecologists issued updated statements on trial of labor after cesarean delivery (TOLAC). This article presents an ethical framework for the informed consent process for TOLAC. Three conclusions are reached. For women with one previous low transverse incision, TOLAC and elective repeat cesarean delivery should be offered. Obstetricians should recommend against TOLAC when a pregnant woman has had a previous classical incision. TOLAC after two previous low transverse incisions may be offered provided that the informed consent process presents the uncertainties of the evidence.
authors.affiliation: Department of Obstetrics and Gynecology, New York-Presbyterian Hospital - Weill Cornell Medical College, New York, NY 10065, USA. fac2001@med.cornell.edu
authors.forename: Frank A
authors.initials: FA
authors.lastname: Chervenak
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D005260:Female; D005333:Fetus; D006806:Human Rights; D006801:Humans; D007258:Informed Consent / Q000941:ethics* / Q000331:legislation & jurisprudence; D011247:Pregnancy; D012307:Risk Factors; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000941:ethics* / Q000331:legislation & jurisprudence