Vaginal birth after cesarean section. Experience in a community-based practice.

The option of vaginal birth after a previous cesarean section (VBAC) is widely recognized as a safe procedure for mother and infant as well as a means of reducing the cesarean section rate. Nevertheless, it remains underutilized in community, non-level III hospitals, where most births occur. Over a 30-month period, all patients presenting to a community-based practice who met the criteria for VBAC as outlined by the American College of Obstetricians and Gynecologists were offered this option. Of 72 candidates, 66 chose a trial of labor; only 4 failed to deliver vaginally. No complications were noted in any of the women or infants. This study demonstrated that in a community setting, VBACs are safe and can yield a high success rate.