Background: • The proportion of women who decline vaginal birth after caesarean section is a significant determinant of overall rates of caesarean birth, hence the need for this audit. Objective: • To assess compliance with Departmental Guideline on Vaginal Delivery following Caesarean Section • To determine Vaginal Birth Rate after single previous Caesarean Section (CS). • To encourage medical staff to use the guideline when managing patients with previous CS. Patients and Methods: • A retrospective review in Antrim Area Hospital, the largest Maternity Unit in the Northern Trust, Northern Ireland. • 96 women with one previous caesarean section with or without history of vaginal delivery were included in the audit. Results: • 66% of women were planned for elective repeat caesarean section (ERCS), while 34% opted to try for vaginal birth after caesarean section (VBAC). Of the 34%, 13% had VBAC while 21% had emergency caesarean section. Overall, the successful VBAC rate was 37%. Conclusions and discussion: • Compared to quoted figures of VBAC rate of 72-76%, we achieved a significantly lower rate of 37%. Could this be because: • of poor selection • we have a better informed obstetric population who are more involved in decision making? • those who plan for fewer children are less frightened of the safety of CS. • patients are scared off as a result of the obligatory discussion of scar dehiscence and potential risks to baby? Caesarean Section in these patients contributes significantly to our overall CS rate.
Wilkinson, C., Mcllwaine, G., Patel, N., Hickey, K., & Hickey, W. (1995, March 18). Vaginal birth after caesarean section. The Lancet. https://doi.org/10.1016/S0140-6736(95)90897-8