title: Vaginal birth after cesarean: an effective method to reduce cesarean.
abstract: Cesarean deliveries represent almost one third of US births. Given that repeat cesarean is the most common single indication for cesarean, trial of labor after cesarean (TOLAC) with subsequent vaginal birth after cesarean (VBAC) is an important mechanism to reduce the overall cesarean rate. The 2010 National Institutes of Health Conference found that one of the biggest barriers to VBAC is the lack of patient access to TOLAC. Many women who currently deliver by repeat cesarean would be candidates for a TOLAC. This manuscript will summarize the evidence on VBAC to help clinicians identify candidates, provide evidence-based counseling, and guide management of TOLAC.
authors: Departments of *Obstetrics and Gynecology †Emergency Medicine ‡Medical Informatics and Clinical Epidemiology §Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon.
authors: Bethany
authors: B
authors: Sabol
authors: Mary Anna
authors: MA
authors: Denman
authors: Jeanne-Marie
authors: JM
authors: Guise
mesh_terms: D017604:Cesarean Section, Repeat / Q000009:adverse effects / Q000379:methods; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D006801:Humans; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D018570:Risk Assessment; D014219:Trial of Labor; D014481:United States; D014597:Uterine Rupture / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data