Vaginal birth after cesarean section in a community hospital: a family practice residency experience.

Several tertiary care, multicenter studies have shown vaginal birth after Cesarean section (VBAC) to be a viable alternative in a select patient population. The premise of our study was that VBAC is a safe option in a community hospital setting. Any patient meeting the criteria of the American College of Obstetricians and Gynecologists (ACOG) was eligible for a trial of labor, and ACOG guidelines regarding mandatory facilities and personnel were followed. One hundred six women with a history of previous Cesarean section were delivered of infants during the study period. Of these, 16 attempted a trial of labor, and 13 (81.3 percent) had vaginal births with minimum morbidity. There were no instances of scar disruption. Thirty-nine percent of the patients who were successful with VBAC had had a previous vaginal birth. By offering VBAC, the participating physicians were able to reduce their repeat Cesarean section rate by 12 percent.