VBAC: Is It Safe for Your Patients?

Vaginal birth after caesarean section (VBAC) is being increasingly considered as an alternative to elective repeat section, in order to help reduce overall caesarean rates and achieve improved perinatal outcomes. This review examines the evidence for the safety of VBAC compared to the traditional practice of "Once a caesarean, always a caesarean." It appears that the incidence of uterine rupture is much lower than previously thought (less than 1%), and that the rates of overall fetal and maternal mortality improve with the use of VBAC. A number of associated treatments such as epidural anesthesia and oxytocin use are also examined.